| Crescent Psychiatry Pllc | |
|
3819 100th St Sw Suite 7-c Lakewood WA 98499-4470 | |
| (253) 588-7911 | |
| (253) 984-6774 |
| Full Name | Crescent Psychiatry Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 3819 100th St Sw, Lakewood, Washington |
| Authorized Official Name and Position | Vanraj Varu (PROVIDER/OWNER) |
| Authorized Official Contact | 2535148076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Psychiatry Pllc 7191 Wagner Way Nw Suite 301 Gig Harbor WA 98335-6909 Ph: (253) 514-8076 | Crescent Psychiatry Pllc 3819 100th St Sw Suite 7-c Lakewood WA 98499-4470 Ph: (253) 588-7911 |
| NPI Number | 1245462134 |
|---|---|
| Provider Enumeration Date | 08/11/2009 |
| Last Update Date | 08/11/2009 |
| Medicare PECOS PAC ID | 3173662798 |
|---|---|
| Medicare Enrollment ID | O20091120000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245462134 | NPI | - | NPPES |
| 0243791 | Other | WA | LABOR & INDUSTRIES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | MD00030816 (Washington) | Primary |
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