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General NPI Number Information
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NPI Number | 1538754858
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Entity Type | Individual
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Provider Name | PHILIP BACANI DNP, CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 1100 9TH AVE
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City | SEATTLE
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State | WA
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Zip | 98101-2756
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Country | US
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Telephone | 206-341-0097
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Fax | 206-583-6580
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Provider Business Mailing Address
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Address Line | 211 POMEROY AVE APT 1202
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City | MERIDEN
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State | CT
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Zip | 06450-1783
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Country | US
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Telephone | 206-288-9475
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Fax |
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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 | AP61182804
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License Number State | WA
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