Basic Information
Provider Information
NPI: 1285162164
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOWNE
FirstName: CRYSTAL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3801 KERN WAY
Address2:  
City: YAKIMA
State: WA
PostalCode: 989026340
CountryCode: US
TelephoneNumber: 5095743256
FaxNumber: 5095743210
Practice Location
Address1: 3801 KERN WAY
Address2:  
City: YAKIMA
State: WA
PostalCode: 989026340
CountryCode: US
TelephoneNumber: 5095743256
FaxNumber: 5095743210
Other Information
ProviderEnumerationDate: 05/23/2017
LastUpdateDate: 05/23/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC1500XRN00153031WAY Nursing Service ProvidersRegistered NurseCommunity Health

No ID Information.


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