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NPI Code Detail

MEDICARE: MR. JOHN E BUONORA CRNA

MEDICARE:  MR. JOHN E BUONORA  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
1367500000XCertified Registered Nurse Anesthetist133435-030WI
2367500000XCertified Registered Nurse AnesthetistAP60879305WA

Other Identifiers

General Provider Information

NPI Number : 1356345185
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN E BUONORA CRNA
Provider Business Mailing Address
First Line : 10901 102ND AVE SW
Second Line :
City : LAKEWOOD
State : WA
Zip : 98498-2909
Country : US
Telephone Number : 240-429-8870
Fax Number :
Provider Business Practice Location Address
First Line : 9040 JACKSON AVE
Second Line :
City : TACOMA
State : WA
Zip : 98431-4933
Country : US
Telephone Number : 253-968-0554
Fax Number : 253-986-3278
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 01/08/2022

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Directions to “ MR. JOHN E BUONORA CRNA” Practice Location

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