Individual
DEBORAH A HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 MT VIEW DR, BUILDING 1, SHELTON, WA 98584-4401
(360) 426-1611
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN00094991
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126457155
TRICARE
WA
05
—
9619263
—
WA
01
—
HA6715
BLUE CROSS OF WA
WA
Enumeration date
03/10/2006
Last updated
04/29/2008
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