Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 60847026 | WA |
NPI | 1326332438 |
---|---|
Provider Name | Mary Elizabeth Crocker |
First Address | Seattle, WA 98105-2202 |
Second Address | Chapel Hill, NC 27599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2011 |
Last Update Date | 24/05/2018 |