Healthcare Provider Details

I. General information

NPI: 1154739662
Provider Name (Legal Business Name): BARBARA ANN BUDINSKY CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14561 CAVALLI RD SE
OLALLA WA
98359-7516
US

IV. Provider business mailing address

PO BOX 938
ROWLETT TX
75030-0938
US

V. Phone/Fax

Practice location:
  • Phone: 724-366-9667
  • Fax:
Mailing address:
  • Phone: 214-227-2457
  • Fax: 214-699-4418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN60177230
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: