Healthcare Provider Details
I. General information
NPI: 1285597633
Provider Name (Legal Business Name): DESPIERTA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/03/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5275 S BRANDON ST
SEATTLE WA
98118-2522
US
IV. Provider business mailing address
5275 S BRANDON ST
SEATTLE WA
98118-2522
US
V. Phone/Fax
- Phone: 206-446-8226
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIC
NELSON
Title or Position: OWNER
Credential: CRNA
Phone: 206-446-8226