Healthcare Provider Details

I. General information

NPI: 1245249234
Provider Name (Legal Business Name): DAVID G MCCANN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3927 RUCKER AVE
EVERETT WA
98201-4833
US

IV. Provider business mailing address

7600 EVERGREEN WAY
EVERETT WA
98203-6421
US

V. Phone/Fax

Practice location:
  • Phone: 425-317-3950
  • Fax:
Mailing address:
  • Phone: 206-860-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP60534430
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number231604/06391
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: