Individual
JOHN A. CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9800 4TH AVE NE, SEATTLE, WA 98115-2152
(206) 302-1300
Mailing address
10570 15TH AVE NW, SEATTLE, WA 98177-5312
(509) 241-7349
(509) 241-7628
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00018613
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232736
L&I
WA
05
—
8440604
—
WA
Enumeration date
01/25/2007
Last updated
03/30/2021
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