MEDICARE: MS. TAMMY RENEE BARRETT CRNA

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	363L00000X	Nurse Practitioner	2192222	FL
2	367500000X	Certified Registered Nurse Anesthetist	AP 60118439	WA
3	367500000X	Certified Registered Nurse Anesthetist	200960025CRNA	OR
4	367500000X	Certified Registered Nurse Anesthetist	ARNP2192222	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346248192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAMMY RENEE BARRETT CRNA

Provider Business Mailing Address
First Line	:	2630 77TH AVE SE
Second Line	:	# 413
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-4053
Country	:	US
Telephone Number	:	206-240-0589
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 116TH AVE NE
Second Line	:	SUITE 570
City	:	BELLEVUE
State	:	WA
Zip	:	98004-4623
Country	:	US
Telephone Number	:	425-451-7335
Fax Number	:	425-451-1226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	09/13/2010

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