Individual
DIANE CRAIGHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
621 77TH AVE NE, OLYMPIA, WA 98506-9775
(360) 786-6781
Mailing address
621 77TH AVE NE, OLYMPIA, WA 98506-9775
(360) 786-6781
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00001272
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5900246
—
WA
Enumeration date
03/28/2007
Last updated
07/08/2007
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