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General NPI Number Information
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NPI Number | 1235133067
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Entity Type | Individual
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Provider Name | SUSAN M MILBACH CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 34503 9TH AVE S SUITE 240
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City | FEDERAL WAY
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State | WA
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Zip | 98003-8727
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Country | US
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Telephone | 253-838-9839
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Fax | 253-661-9077
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Provider Business Mailing Address
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Address Line | 2420 S UNION AVE STE 200
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City | TACOMA
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State | WA
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Zip | 98405-1323
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Country | US
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Telephone | 253-503-2598
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Fax | 253-682-2427
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP60089224
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024164185
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License Number State | VA
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