Individual
MISS CRYSTALIN RAY MCREYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D161066205
Contact information
Practice address
5100 W CLEARWATER AVE APT H201, KENNEWICK, WA 99336-2095
(509) 820-1947
Mailing address
5100 W CLEARWATER AVE APT H201, KENNEWICK, WA 99336-2095
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IJR971204865
BLUE CROSS
WA
Enumeration date
01/08/2021
Last updated
01/08/2021
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