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Individual

JEREMIAH JACOB CRANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 501-3601
(360) 501-3648
Mailing address
1115 SE 164TH AVE, DEPT. 358, VANCOUVER, WA 98683-9324
(360) 729-1462
(360) 729-3104

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60315265
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2024337
WA
05
500715191
OR
Enumeration date
04/01/2008
Last updated
02/16/2017
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