Individual
EMANUEL NISTRIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3901 CAPITAL MALL DR SW STE B, OLYMPIA, WA 98502-8654
(360) 528-8571
Mailing address
PO BOX 368, OLYMPIA, WA 98507-0368
(360) 455-5144
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60309732
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP61320756
WA
367500000X
Certified Registered Nurse Anesthetist
RNA21366
ME
390200000X
Student in an Organized Health Care Education/Training Program
60309732
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2278162
—
WA
Enumeration date
05/31/2019
Last updated
04/30/2024
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