Charles J Creveling, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10001183 Issued in WA

Practice address

904 7TH Ave
Seattle, WA 98104-1132

Phone

(206) 223-6487

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.creveling@direct.vmmc.org

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.

• Virginia Mason Medical Center

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Seattle, WA
  • NPI 1043375587
  NPD
• Virginia Mason Medical Center

  • Surgery Physician
  • Seattle, WA
  • NPI 1154487452
  NPD
• Virginia Mason Medical Center

  • Certified Registered Nurse Anesthetist
  • Seattle, WA
  • NPI 1164586020
  NPD
• Virginia Mason Medical Center

  • Podiatrist
  • Seattle, WA
  • NPI 1215085097
  NPD
• Virginia Mason Medical Center

  • Cardiovascular Disease Physician
  • Seattle, WA
  • NPI 1225193766
  NPD
• Virginia Mason Medical Center

  • Dermatology Physician
  • Seattle, WA
  • NPI 1235293101
  NPD
• Virginia Mason Medical Center

  • Registered Dietitian
  • Seattle, WA
  • NPI 1235295536
  NPD
• Virginia Mason Medical Center

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1316094816
  NPD
• Virginia Mason Medical Center

  • Pulmonary Disease Physician
  • Seattle, WA
  • NPI 1346304201
  NPD
• Virginia Mason Medical Center

  • Speech-Language Pathologist
  • Seattle, WA
  • NPI 1407911944
  NPD
• Virginia Mason Medical Center

  • Urology Physician
  • Seattle, WA
  • NPI 1588712376
  NPD
• Virginia Mason Medical Center

  • Neurology Physician
  • Seattle, WA
  • NPI 1598821894
  NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1992842033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 OLIVE WAY MSC M4-PA",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011873",
            "telephone_number": "206-511-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 7TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-223-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREVELING",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10001183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US0863643",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "CR2541",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES#",
            "identifier": "0171808",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8368086",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crescendo Mind & Wellness PLLC
• Magdalena Crescenzo
• Jennifer Creson, LMHC
• Lucy Fort Cress
• Claire J. Creutzfeldt, MD
• Alison Leigh Crevi, ARNP
• Jennifer J. Crew
• Laura Kristina Crew, NP-C
• Amanda Crews, LMT
• Kaelin Eileen Crews, MD

• Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.

Verify at the official NPI Registry.