Individual provider Active NPI

Jesse Crawford

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1326424474
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MA60496962 Issued in WA
Practice address
703 Broadway St Ste 500
Vancouver, WA 98660-3307
Phone
(360) 690-0081
NPI assigned
Jul 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MA60496962 WA Primary

Addresses

Primary practice location

703 Broadway St Ste 500
Vancouver, WA 98660-3307

Mailing address

12615 SE Bush St
Portland, OR 97236-3422
Phone (503) 730-9791

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)
Not enrolled
Credentials
Master of Theology

State licenses

LicenseStateTypeSpecialty
MA60496962WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fearn Natural Health Care, Inc. PC Chiropractor PastSince May 28, 1998 Accepting new patients
Hutton Chiropractic Clinic Inc Chiropractor PastSince Jan 17, 2018 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1326424474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12615 SE BUSH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363422",
            "telephone_number": "503-730-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 BROADWAY ST STE 500",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603307",
            "telephone_number": "360-690-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "JESSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "MA60496962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.