Basic Information
| Provider Information | |||||||||
| NPI: | 1104890748 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORROW | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17315 N BROOKSIDE LN | ||||||||
| Address2: | |||||||||
| City: | COLBERT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 990059454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094667135 | ||||||||
| FaxNumber: | 5094347106 | ||||||||
| Practice Location | |||||||||
| Address1: | 4815 N ASSEMBLY ST | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992056185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094347000 | ||||||||
| FaxNumber: | 5094347106 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | AP30005314 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | AP30005314 | 01 | WA | ADVANCED RN PRACTITIONER | OTHER | 178749-1 | 01 | NY | REGISTERED NURSE | OTHER | RN00055138 | 01 | WA | REGISTERED NURSE | OTHER |