Active NPI
J. Chriss Cancro, MD
- Specialist
- Auburn, WA
National Provider Identifier
1245218668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD00015504
- Practice address
- 122 3Rd St NE
Auburn, WA 98002-4013 - Phone
- (253) 833-7750
- Fax
- (253) 887-9804
- NPI assigned
- Jan 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD00015504 | WA | Primary |
Addresses
Primary practice location
122 3Rd St NE
Auburn, WA 98002-4013
Mailing address
122 3Rd St NE
Auburn, WA 98002-4013
Phone (253) 833-7750
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 69849 | Other | WA | LABOR & INDUSTRIES |
| 1151406 | Other | WA | DSHS |
| C142 | Other | WA | REGENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207872000000",
"number": "1245218668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 3RD ST NE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980024013",
"telephone_number": "253-833-7750",
"fax_number": "253-887-9804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 3RD ST NE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980024013",
"telephone_number": "253-833-7750",
"fax_number": "253-887-9804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANCRO",
"first_name": "J.",
"middle_name": "CHRISS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-05",
"last_updated": "2008-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MD00015504",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "69849",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DSHS",
"identifier": "1151406",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "C142",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.