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NPI 1598792186

NPI 1598792186 : WILLIAM LEE TAYLOR CRNA : KENNEWICK, WA

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General NPI Number Information
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    NPI Number           |    1598792186
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM LEE TAYLOR CRNA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/27/2006
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    Last Update Date     |    12/11/2020
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Provider Practice Location Address
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    Address Line         |    6695 W RIO GRANDE AVE 
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    City                 |    KENNEWICK
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    State                |    WA
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    Zip                  |    99336-3301
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    Country              |    US
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    Telephone            |    509-736-0826
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    Fax                  |    509-735-6868
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1506 
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    City                 |    CHEHALIS
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    State                |    WA
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    Zip                  |    98532-0409
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    Country              |    US
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    Telephone            |    360-242-3008
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    Fax                  |    360-807-7687
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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       |    200860027CRNA
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    License Number State |    OR
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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       |    RNA-530
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    License Number State |    ID
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Taxonomy #3
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    AP60056924
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    License Number State |    WA
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