Provider Demographics
NPI:1447486170
Name:CRECELIUS, CHRISTOPHER ERIC (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ERIC
Last Name:CRECELIUS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-8075
Mailing Address - Country:US
Mailing Address - Phone:360-683-7711
Mailing Address - Fax:
Practice Address - Street 1:3425 ENSIGN RD NE STE 310
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5063
Practice Address - Country:US
Practice Address - Phone:360-456-5678
Practice Address - Fax:360-456-1238
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000088821223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery