Healthcare Provider Details

I. General information

NPI: 1841464237
Provider Name (Legal Business Name): DANA DAWN MARTIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 SE BISHOP BLVD
PULLMAN WA
99163-5512
US

IV. Provider business mailing address

406 S 30TH AVE SUITE 202
YAKIMA WA
98902-3713
US

V. Phone/Fax

Practice location:
  • Phone: 509-336-0279
  • Fax:
Mailing address:
  • Phone: 509-972-1051
  • Fax: 509-972-4166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP30008037
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: