Healthcare Provider Details

I. General information

NPI: 1891805214
Provider Name (Legal Business Name): WHITMAN ANESTHESIA PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W FAIRVIEW ST
COLFAX WA
99111-9552
US

IV. Provider business mailing address

21980 E COUNTRY VISTA DR STE 200
LIBERTY LAKE WA
99019-6025
US

V. Phone/Fax

Practice location:
  • Phone: 509-397-3435
  • Fax:
Mailing address:
  • Phone: 509-926-1770
  • Fax: 509-228-9542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: PAUL B SULLIVAN
Title or Position: PRESIDENT
Credential: CRNA
Phone: 509-926-1770