Individual
ABRAHAM CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1253 NW CANAL BLVD, REDMOND, OR 97756-1334
(541) 526-6576
(541) 526-6675
Mailing address
PO BOX 2847, CORVALLIS, OR 97339-2847
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201041236RN
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
201507563CRNA-PP
OR
Other
Enumeration date
08/20/2015
Last updated
01/24/2025
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