MEDICARE: MR. PATRICK LUDWIG KLIMCZYK 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	367500000X	Certified Registered Nurse Anesthetist	AP30007604	WA

General Provider Information

NPI Number	:	1700923026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK LUDWIG KLIMCZYK CRNA

Provider Business Mailing Address
First Line	:	2801 NW 93RD ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98117-2936
Country	:	US
Telephone Number	:	605-660-3205
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 NW 93RD ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98117-2936
Country	:	US
Telephone Number	:	605-660-3205
Fax Number	:

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/02/2008

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