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NPI Code Detail

MEDICARE: OLYMPIC ANESTHESIA INC PC

MEDICARE: OLYMPIC ANESTHESIA INC PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistAP30005901WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255396701
Entity Type Code : Organization
Provider Name (Legal Business Name) : OLYMPIC ANESTHESIA INC PC
Provider Business Mailing Address
First Line : 409 LANE DE CHANTAL
Second Line :
City : PORT TOWNSEND
State : WA
Zip : 98368-8815
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 834 SHERIDAN ST
Second Line :
City : PORT TOWNSEND
State : WA
Zip : 98368-2443
Country : US
Telephone Number : 360-385-2200
Fax Number :
Authorized Official
Title or Position : CRNA
Name : COLUM P TINLEY
Credential : CRNA
Telephone Number : 360-385-5244
Provider Enumeration Date : 04/18/2006
Last Update Date : 04/21/2011

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Directions to “OLYMPIC ANESTHESIA INC PC ” Practice Location

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