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General NPI Number Information
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NPI Number | 1417962200
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Entity Type | Organization
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Legal Business Name | PHYSICIANS ANESTHESIA SERVICE PLLC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 600 BROADWAY STE 270
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City | SEATTLE
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State | WA
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Zip | 98122-5392
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Country | US
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Telephone | 206-381-0269
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Fax | 206-829-2083
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Provider Business Mailing Address
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Address Line | 600 BROADWAY STE 270
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City | SEATTLE
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State | WA
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Zip | 98122-5392
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Country | US
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Telephone | 206-381-0269
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Fax | 206-829-2083
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE
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Name | MS. TERESE PARKER-BLACK
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Credential |
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Telephone | 360-261-4271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 600084653
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License Number State | WA
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