JESSICA RENAE CRADDOCK (NPI# 1154614469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154614469 |
| Entity Type | Individual |
| Full Name | JESSICA RENAE CRADDOCK |
| Credential | MD |
| Practice Address |
212 E Central Ave Suite 440 Spokane WA 99208-6291 |
| Mailing Address |
Po Box 421 Liberty Lake WA 99019-0421 |
| Practice Telephone | 5092529602 |
| Practice Fax Number | 5097899031 |
| Mailing Telephone | 8667472455 |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2018-05-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MD60644738 | WA | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD60644738 | WA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 173365 | NC | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255874277 | Jessica Craddock | Physical Therapy Assistant | 7600 Antioch Rd, Overland Park, KS 66204-2622 | 2016-11-22 |
| Street Address |
212 E CENTRAL AVE SUITE 440 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-6291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477550572 | Philip Coff | Internal Medicine | 212 E Central Ave, Suite 440, Spokane, WA 99208-6291 | 2005-07-05 |
| 1881059954 | Providence Health & Services Washington | Prosthetic/Orthotic Supplier | 212 E Central Ave, Suite 245, Spokane, WA 99208-6291 | 2015-12-16 |
| 1881096774 | Timothy Brim | Physician Assistant | 212 E Central Ave, Suite 365, Spokane, WA 99208-6291 | 2014-09-23 |
| 1295135598 | Providence Physician Services Co. | Orthopaedic Surgery | 212 E Central Ave, Suite 245, Spokane, WA 99208-6291 | 2014-08-25 |
| 1841605433 | Nicole Breen | Family Medicine | 212 E Central Ave, Spokane, WA 99208-6291 | 2014-06-23 |
| 1639471667 | Daniel J Simon | Physician Assistant | 212 E Central Ave, Suite 440, Spokane, WA 99208-6291 | 2010-11-24 |
| 1609182070 | David Bryan Ramey | Psychiatry & Neurology | 212 E Central Ave, Suite 315, Spokane, WA 99208-6291 | 2010-08-24 |
| 1942513874 | Providence Health & Services - Washington | Internal Medicine | 212 E Central Ave, Suite 240, Spokane, WA 99208-6289 | 2010-07-20 |
| 1154648814 | Providence Physician Services Co | Family Medicine | 212 E Central Ave, Ste 440, Spokane, WA 99208-6291 | 2010-04-21 |
| 1528385283 | Providence Physician Services Co | Family Medicine | 212 E Central Ave, Ste 440, Spokane, WA 99208-6290 | 2010-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730683053 | Selkirk Neurology Pllc | Psychiatry & Neurology | 610 S Sherman St Ste 201, Spokane, WA 99202-1342 | 2018-03-21 |
| 1962740274 | Legacy Neuromonitoring, LLC | Psychiatry & Neurology | 1818 W Francis Ave, Pmb #299, Spokane, WA 99205-6834 | 2013-01-21 |
| 1477690618 | Neurology Associates of Spokane | Psychiatry & Neurology | 715 S Cowley St Ste 224, Spokane, WA 99202-1384 | 2007-01-30 |
| 1801962923 | John Robert Clark | Psychiatry & Neurology | 42 East Rowan Suite B, Spokane, WA 99207 | 2006-11-28 |
| 1386758712 | David R Greeley | Psychiatry & Neurology | 26 E 5th Ave, Spokane, WA 99202-1309 | 2006-08-19 |
| 1447263769 | Nydia Margarita Melendez-brugueras | Psychiatry & Neurology | 910 W 5th Ave Ste 1000, Spokane, WA 99204-2975 | 2006-08-15 |
| 1245246990 | John Edward Chapin | Psychiatry & Neurology | 105 W 8th Ave Ste 318c, Spokane, WA 99204-2318 | 2006-08-01 |
| 1851344329 | Sylvia B Rojas | Psychiatry & Neurology | 12519 N Division St Ste 4, Spokane, WA 99218-1936 | 2006-05-18 |
| 1366445702 | Joseleeto Chua | Psychiatry & Neurology | 400 E 5th Ave, Spokane, WA 99202-1334 | 2005-05-31 |
| 1972506814 | Jennifer Kay Pary | Psychiatry & Neurology | 105 W 8th Ave, Suite 318c, Spokane, WA 99204-2302 | 2005-05-24 |
| Find all providers in SPOKANE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.