Healthcare Provider Details

I. General information

NPI: 1386146173
Provider Name (Legal Business Name): ERIN ELEANOR MILLS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN ELEANOR SELF RN

II. Dates (important events)

Enumeration Date: 03/07/2018
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 8TH AVE
SPOKANE WA
99204-2307
US

IV. Provider business mailing address

PO BOX 4069
EVERETT WA
98204-0007
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-3181
  • Fax:
Mailing address:
  • Phone: 425-407-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP60829599
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: