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NPI Code Detail

MEDICARE: LAURA A. CASTLEBERRY CRNA

MEDICARE: LAURA A. CASTLEBERRY CRNA
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
1163W00000XRegistered NurseRN00142650WA
2367500000XCertified Registered Nurse AnesthetistAP30006034WA

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 : 1316992290
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA A. CASTLEBERRY CRNA
Provider Business Mailing Address
First Line : PO BOX 94061
Second Line :
City : SEATTLE
State : WA
Zip : 98124-9461
Country : US
Telephone Number : 425-353-3788
Fax Number : 425-353-8041
Provider Business Practice Location Address
First Line : 330 S STILLAGUAMISH AVE
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-1642
Country : US
Telephone Number : 206-435-2133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 11/19/2007

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