Individual
ROSALYN E. CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
5350 SW ERICKSON AVE, BEAVERTON, OR 97005-3849
(503) 641-5280
Mailing address
5350 SW ERICKSON AVE, BEAVERTON, OR 97005-3849
(503) 641-5280
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
080045436RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098900
—
OR
Enumeration date
10/13/2006
Last updated
11/21/2008
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