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General NPI Number Information
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NPI Number | 1518712678
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Entity Type | Organization
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Legal Business Name | EW ANESTHESIA PLLC
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 30544 HIGHWAY 200 STE 201
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City | PONDERAY
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State | ID
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Zip | 83852-5005
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Country | US
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Telephone | 208-265-8194
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Fax |
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Provider Business Mailing Address
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Address Line | 713 N CENTER VALLEY RD
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City | SANDPOINT
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State | ID
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Zip | 83864-7149
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELISE WEBB
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Credential | CRNA
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Telephone | 208-967-4864
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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 |
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License Number State |
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