Crystal Lee Wynne

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CG61446275 Issued in WA

Practice address

901 N Monroe St
Spokane, WA 99201-2104

Phone

(509) 771-6572

NPI assigned

Oct 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1487436671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1657 E LONGFELLOW AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992074321",
            "telephone_number": "509-496-3163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N MONROE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012104",
            "telephone_number": "509-771-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "CRYSTAL",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61446275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Wyer, DO
• Donald Todd Wylie, O.D.
• Ian Keith Wyma
• Kelsey Wyman
• Michael J Wymore, MD
• Jared Wyrick, M.D.
• Carol H Wysham, MD
• Jennifer M Xiao, M.D.
• Patricia Jeanne Yacker, LMHC
• Aimee Jo Yaeger

• Peer Specialist in Spokane, WA
• Providers in Spokane, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.