Basic Information
| Provider Information | |||||||||
| NPI: | 1669501029 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PACIFIC NORTH WEST ANESTHETISTS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4957 LAKEMONT BLVD SE | ||||||||
| Address2: | BUILDING C-4 - SUITE 175 | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980067801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252608060 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1101 MADISON ST | ||||||||
| Address2: | SUITE 1050 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981041306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065150000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ERB | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
| AuthorizedOfficialMiddleName: | WILLIAM | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4257467513 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | ARNP,CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | AP30004547 | WA | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.