Provider Demographics
NPI:1578889218
Name:CRAMER, STEPHANIE K (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:K
Last Name:CRAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 TRIANGLE SHOPPING CTR STE 400
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-4677
Mailing Address - Country:US
Mailing Address - Phone:360-423-0220
Mailing Address - Fax:360-423-0697
Practice Address - Street 1:600 TRIANGLE SHOPPING CTR STE 400
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-4677
Practice Address - Country:US
Practice Address - Phone:360-423-0220
Practice Address - Fax:360-423-0697
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD165857207W00000X
WAMD60883450207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500656256Medicaid
WA2027826Medicaid