Josephine Crocker, CHW
Individual provider Active NPI Community Health Worker · Stayton, OR
NPI 1124761796 · NPPES record last updated Apr 20, 2022
Key facts
- NPI
- 1124761796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- License
- THW000106362 (OR)
- Practice address
- 1401 N 10TH Ave
Stayton, OR 97383-1311 - Phone
- (541) 650-8304
- NPI assigned
- Apr 20, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| THW000106362 | OR | MD | Community Health Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | THW000106362 | OR | Yes |
Addresses
Primary practice location
1401 N 10TH Ave
Stayton, OR 97383-1311
Mailing address
1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-2175
Other practice location 1
280 S 1st Ave
Mill City, OR 97360-2324
Phone (541) 650-8304
Other providers in Stayton, OR
- Marissa Colberg
- Cory M. Smith, DMD, L.L.C.
- Craven & Wright MDS PC
- Joanna L Crawford
- Sheila Marie Crispin
- Kim Dang
- Daren L. Goin, DMD, PC
- Davenport Mental Health, LLC
- Richard Wolfgang Davenport
- Spencer J De Los Reyes
All providers in Stayton, OR · Community Health Worker in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.