Healthcare Provider Details

I. General information

NPI: 1033374657
Provider Name (Legal Business Name): AMBER GEORGE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER LAING

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 8TH AVE
SPOKANE WA
99204
US

IV. Provider business mailing address

PO BOX 94645
SEATTLE WA
98124-6945
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-3181
  • Fax: 509-227-7070
Mailing address:
  • Phone: 706-650-0705
  • Fax: 509-227-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3616
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number56417
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP60834505
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number638423
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: