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General NPI Number Information
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NPI Number | 1902684228
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Entity Type | Organization
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Legal Business Name | BR ANESTHESIA-WA PLLC
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 4115 NE 137TH CIR
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City | VANCOUVER
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State | WA
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Zip | 98686-2612
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Country | US
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Telephone | 208-890-6251
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Fax | 888-492-0360
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Provider Business Mailing Address
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Address Line | 4115 NE 137TH CIR
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City | VANCOUVER
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State | WA
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Zip | 98686-2612
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Country | US
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Telephone | 208-890-6251
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Fax | 888-492-0360
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Authorized Official
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Title or Position | PRESIDENT
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Name | BURKE ONEAL
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Credential | MD
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Telephone | 208-890-6251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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