Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PY00001360 | WA |
N | 103T00000X | Psychologist | PY00001360 | WA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY00001360 | WA |
Y | 103G00000X | Clinical Psychologist | PY00001360 | WA |
Y | 103TC0700X | Clinical Psychologist | PY00001360 | WA |
N | 103TC1900X | Counseling Psychologist | PY00001360 | WA |
NPI | 1023148269 |
---|---|
Provider Name | Dr. William Jeffrey Crinean |
First Address | Lacey, WA 98503-1000 |
Second Address | Lacey, WA 98503-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 06/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0218559 | LABOR AND INDUSTRY (01) | WA |
115000792 | (02) | WA |