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Individual

LEDJIE R. BALLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 543-2470
Mailing address
PO BOX 24975, SEATTLE, WA 98124-0975
(425) 353-2840
(425) 353-8041

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00080666
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30005027
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03644U
REGENCE BLUESHIELD
WA
05
9620683
WA
Enumeration date
04/04/2006
Last updated
10/10/2007
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