Healthcare Provider Details

I. General information

NPI: 1770772188
Provider Name (Legal Business Name): RENEE ELIZABETH SLIKER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

523 BROADWAY E APARTMENT 230
SEATTLE WA
98102-5218
US

V. Phone/Fax

Practice location:
  • Phone: 312-515-1186
  • Fax:
Mailing address:
  • Phone: 312-515-1186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704240521
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP60241460
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: