Individual
MRS. CRYSTAL LEE HARTSHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA00019153
Contact information
Practice address
1004 NE MINNEHAHA ST, VANCOUVER, WA 98665-8728
(360) 977-4753
Mailing address
35201 NE SUNSET FALLS RD, YACOLT, WA 98675-9513
(360) 953-7644
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00019153
WA
Other
Enumeration date
05/01/2012
Last updated
05/01/2012
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