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General NPI Number Information
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NPI Number | 1851599559
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Entity Type | Organization
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Legal Business Name | R M ANESTHESIA SERVICES PLLC
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 708 212TH PL SW
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City | LYNNWOOD
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State | WA
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Zip | 98036-8606
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Country | US
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Telephone | 425-672-7275
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Fax | 425-744-0117
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Provider Business Mailing Address
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Address Line | 708 212TH PL SW
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City | LYNNWOOD
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State | WA
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Zip | 98036-8606
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Country | US
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Telephone | 425-672-7275
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Fax | 425-744-0117
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Authorized Official
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Title or Position | NURSE ANESTHETIST
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Name | ROBERT ALLEN MILDES
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Credential | CRNA
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Telephone | 425-672-7275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 025804 30004423
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License Number State | WA
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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 | AP30004423
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License Number State | WA
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