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CRICKETT RENEE MADDOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4121 HESSELTINE RD, VALLEY, WA 99181-9646
(509) 380-7043
Mailing address
4121 HESSELTINE RD, VALLEY, WA 99181-9646
(509) 380-7043

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60354027
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MADDOCR208LQ
DRIVER'S LICENSE
WA
01
RN60354027
REGISTERED NURSE
WA
Enumeration date
06/19/2017
Last updated
06/19/2017
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