Individual
KEANA S CRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDT
Contact information
Practice address
17395 RESERVATION RD, LA CONNER, WA 98257-8802
(360) 466-3900
Mailing address
309 N 21ST ST APT 1, MOUNT VERNON, WA 98273-3565
(509) 385-9299
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DETLDD70095998
WA
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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