MEDICARE: MRS. JENNIFER SAN FISHER 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
1	367500000X	Certified Registered Nurse Anesthetist	AP60271083	VA
2	367500000X	Certified Registered Nurse Anesthetist	AP60271083	WA
3	163WC0200X	Critical Care Medicine Registered Nurse	0001167107	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP60271083	OTHER		LICENSE
2	RN60247840	OTHER	WA	LICENSE

General Provider Information

NPI Number	:	1699847947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER SAN FISHER CRNA

Provider Business Mailing Address
First Line	:	1814 BEACON CT NE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98422-3469
Country	:	US
Telephone Number	:	206-679-3558
Fax Number	:

Provider Business Practice Location Address
First Line	:	1814 BEACON CT NE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98422-3469
Country	:	US
Telephone Number	:	206-679-3558
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	02/17/2026

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