=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679871222
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KARA KAISER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2011
-----------------------------------------------------
Last Update Date | 03/07/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9236 26TH AVE NW
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98117-2815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-499-9204
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9236 26TH AVE NW
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98117-2815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-499-9204
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CRNA
-----------------------------------------------------
Name | KARA KAISER
-----------------------------------------------------
Credential | RN, CRNA
-----------------------------------------------------
Telephone | 206-499-9204
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number | AP30007770
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------