Healthcare Provider Details

I. General information

NPI: 1568647808
Provider Name (Legal Business Name): RUTHE ERAKER GRAYBEAL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. RUTHE MARGARET ERAKER

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N 115TH ST
SEATTLE WA
98133-8401
US

IV. Provider business mailing address

209 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4267
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax:
Mailing address:
  • Phone: 253-596-3300
  • Fax: 253-596-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00137578
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP30007968
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: