Healthcare Provider Details

I. General information

NPI: 1336165182
Provider Name (Legal Business Name): GALLATIN VALLEY ANESTHESIA ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 HIGHLAND BLVD
BOZEMAN MT
59715-6900
US

IV. Provider business mailing address

PO BOX 84891
SEATTLE WA
98124-6191
US

V. Phone/Fax

Practice location:
  • Phone: 406-414-5000
  • Fax:
Mailing address:
  • Phone: 425-407-1500
  • Fax: 425-407-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LUKE VAN ALSTINE
Title or Position: PRESIDENT
Credential: MD
Phone: 406-531-3881