Healthcare Provider Details

I. General information

NPI: 1114438991
Provider Name (Legal Business Name): DONALD R MISSEL CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 11/16/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

1660 S COLUMBIAN WAY ANESTHESIA DEPARTMENT
SEATTLE WA
98108-1532
US

V. Phone/Fax

Practice location:
  • Phone: 800-329-8387
  • Fax:
Mailing address:
  • Phone: 800-329-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP61486201
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: