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NPI Code Detail

MEDICARE: MARK J COHEN CRNA, ARNP

MEDICARE: MARK J COHEN CRNA, ARNP
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
1367500000XCertified Registered Nurse Anesthetist085073617CRNAOR
2367500000XCertified Registered Nurse AnesthetistAP30005237WA
3367500000XCertified Registered Nurse AnesthetistAP300005237WA

General Provider Information

NPI Number : 1811981764
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK J COHEN CRNA, ARNP
Provider Business Mailing Address
First Line : 1319 NW 110TH ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98685-4042
Country : US
Telephone Number : 503-317-2084
Fax Number :
Provider Business Practice Location Address
First Line : 400 NE MOTHER JOSEPH PL
Second Line :
City : VANCOUVER
State : WA
Zip : 98664-3200
Country : US
Telephone Number : 360-514-4026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 06/10/2024

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