Individual
MR. ANDREY BOBROVNIKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6341
(253) 426-6344
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(844) 364-2778
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60466902
WA
367500000X
Certified Registered Nurse Anesthetist
R1547371
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2042307
—
WA
Enumeration date
02/25/2011
Last updated
12/01/2020
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