Individual
MICHAEL MAGENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1015 E 'D' STREET, DEER PARK, WA 99006-0742
(509) 276-5061
Mailing address
910 N WASHINGTON ST, SUITE 209, SPOKANE, WA 99201-2202
(509) 232-1173
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30005199
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9617507
—
WA
Enumeration date
12/13/2006
Last updated
12/10/2007
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