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THALIA-RAE CRIDDLE PLLC NPI 1063181709


NPI Information

NPI: 1063181709
Provider Name: THALIA-RAE CRIDDLE PLLC
Classification: Clinic/Center - 261QS0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
1625 SE 192ND AVE STE 205
CAMAS, WA
ZIP 98607
Phone: (617) 762-6661
Get Directions

THALIA-RAE CRIDDLE PLLC is an oral and maxillofacial surgery clinic center in Camas, WA. The provider is an oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. THALIA-RAE CRIDDLE PLLC NPI is 1063181709. The provider is registered as an organization entity type.

The provider's business location address is:

1625 SE 192ND AVE STE 205
CAMAS, WA
ZIP 98607-441
Phone: (617) 762-6661

The provider's authorized official is Thalia-rae Criddle .
The authorized official title is Owner and has the following contact phone number (617) 762-6661.

The enumeration date for this NPI number is 9/7/2021 and was last updated on 9/7/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QS0112XClinic/CenterOral and Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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