MEDICARE: ERIN RENEE ANESTHESIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1013528850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIN RENEE ANESTHESIA LLC

Provider Business Mailing Address
First Line	:	1214 10TH AVE W
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98119-3419
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 112TH AVE NE STE 150
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-4570
Country	:	US
Telephone Number	:	425-450-0880
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIN BERNSTEIN
Credential	:	CRNA
Telephone Number	:	206-612-9806

Provider Enumeration Date	:	08/14/2020
Last Update Date	:	08/14/2020

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