Healthcare Provider Details

I. General information

NPI: 1346525466
Provider Name (Legal Business Name): ERIN POPE BEESLEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2011
Last Update Date: 03/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 MADISON ST STE 1440 SUITE M201
SEATTLE WA
98104-3538
US

IV. Provider business mailing address

990 SYLVAN WAY
BREMERTON WA
98310-2851
US

V. Phone/Fax

Practice location:
  • Phone: 206-625-0578
  • Fax: 206-625-9184
Mailing address:
  • Phone: 360-479-3657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP60411092
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: