Individual
DR. KEITH JENSEN CRIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
202 N DIVISION ST, STE.405, PLAZA 2, AUBURN, WA 98001-4939
(253) 939-3604
(253) 735-4167
Mailing address
202 N DIVISION ST, STE.405, PLAZA 2, AUBURN, WA 98001-4939
(253) 939-3604
(253) 735-4167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00016784
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010037194
RAILROAD MEDICARE
WA
05
—
8107302
—
WA
Enumeration date
06/15/2006
Last updated
04/22/2008
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