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Contact Information

EDGAR P CROCKETT, OD
70 ANDOVER PARK W
TUKWILA, WA98188
 Phone: 206-439-7588
 Fax: 206-241-6857
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for EDGAR P CROCKETT · (Male)

NPI Number 1801955737
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 12/06/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # OD00001214
  • WA Medicaid 2021384
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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