Individual
DR. CRAIG LONGRIDGE SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
942 CEDAR LAKE CT SE, OLYMPIA, WA 98501-9715
(360) 481-8186
Mailing address
942 CEDAR LAKE CT SE, OLYMPIA, WA 98501-9715
(360) 481-8186
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00026911
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8116519
—
WA
Enumeration date
10/17/2006
Last updated
07/08/2007
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