Individual
MS. SEAHEART CRUMPTON ELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT-OR(ADD);LMP-WA(I
Contact information
Practice address
539 MOFFITT ROAD, WALDPORT, OR 97394
(541) 563-8333
(360) 385-2117
Mailing address
PO BOX 2588, WALDPORT, OR 97394
(541) 563-8333
(360) 385-2117
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00010469
WA
Other
Enumeration date
07/19/2007
Last updated
08/01/2011
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