Individual provider · Type 1 NPI

Everett James Crockett, PHAI.IR.61593108

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

NPI number 1104762012 Active

Practice location

205 E Spokane Falls Blvd
Spokane, WA 99202

Call (509) 368-6700 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XPHAI.IR.61593108 (WA)

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 1104762012

Everett James Crockett, PHAI.IR.61593108's National Provider Identifier is 1104762012, issued on Apr 24, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Spokane, WA. The record was last updated on Apr 24, 2026.