Basic Information
Provider Information
NPI: 1811270440
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CRAWFORD
FirstName: HENRY
MiddleName: PALMER
NamePrefix: MR.
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1600 E OLIVE ST
Address2: SOUND MENTAL HEALTH
City: SEATTLE
State: WA
PostalCode: 981222735
CountryCode: US
TelephoneNumber: 2063022200
FaxNumber: 2063022210
Practice Location
Address1: 6100 SOUTHCENTER BLVD
Address2: SOUND MENTAL HEALTH
City: TUKWILA
State: WA
PostalCode: 981882441
CountryCode: US
TelephoneNumber: 2063022200
FaxNumber: 2063022210
Other Information
ProviderEnumerationDate: 09/20/2011
LastUpdateDate: 09/20/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
172V00000X  Y Other Service ProvidersCommunity Health Worker 

No ID Information.


Home