Individual provider · Type 1 NPI

Ivan Cruse, MD

Student in an Organized Health Care Education/Training Program · Grandview, WA

NPI number 1013769553 Active

Practice location

1000 Wallace Way
Grandview, WA 98930-8805

Call (509) 882-3444 Map

Mailing address

12636 Agave Bay St
Victorville, CA 92392-4817

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1013769553

Ivan Cruse, MD's National Provider Identifier is 1013769553, issued on Apr 5, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Grandview, WA. The record was last updated on Apr 5, 2024.