Individual
NIKKI R CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
33501 1ST WAY S, FEDERAL WAY, WA 98003-6208
(253) 838-2400
Mailing address
1100 OLIVE WAY MSC M4-PA, SEATTLE, WA 98101-1873
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10004560
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039594
LABOR AND INDUSTRIES #
WA
01
—
7374WI
BLUE SHIELD #
WA
05
—
8388159
—
WA
01
—
P00088504
RAILROAD MEDICARE #
WA
01
—
US7831554
AETNA SPECIALIST PIN
WA
Enumeration date
01/09/2007
Last updated
02/12/2013
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