Crescent Psychiatry PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

MD00030816 Issued in WA

Legal business name

CRESCENT PSYCHIATRY PLLC

Practice address

3819 100TH St SW
Suite 7-C
Lakewood, WA 98499-4470

Phone

(253) 588-7911

Fax

(253) 984-6774

NPI assigned

Aug 11, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Vanraj Varu, MD

Title

Provider/Owner

Phone

(253) 514-8076

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Makiko Guji

  • Clinical Psychologist
  • Lakewood, WA
  • NPI 1003959891
  NPD (past)
• Lydia Saule Huber, MSW, LICSW, C-SSWS

  • Clinical Social Worker
  • Federal Way, WA
  • NPI 1710112834
  NPD (past)
• Laurel C Kelso, LCSW

  • Clinical Social Worker
  • Gig Harbor, WA
  • NPI 1245478064
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1245462134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7191 WAGNER WAY NW",
            "address_2": "SUITE 301",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983356909",
            "telephone_number": "253-514-8076",
            "fax_number": "253-514-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 100TH ST SW",
            "address_2": "SUITE 7-C",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994470",
            "telephone_number": "253-588-7911",
            "fax_number": "253-984-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-11",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "VARU",
        "authorized_official_first_name": "VANRAJ",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "253-514-8076",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "MD00030816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0243791",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanisha Crain
• Jennifer Cravens, RN
• Creekside Chiropractic and Massage, PS
• Kathryn Ann Cregan, LICSW
• Erika Creighton
• Patrick Steven Crews, HS
• Critical Medical Solutions Inc
• Meredith Cromis
• Phillip Damon Cronin, D.D.S.
• Emily Ann Cronk

• Clinical Psychologist in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.