Individual
CALVIN MULYADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6980
(206) 223-6982
Mailing address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6980
(206) 223-6982
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-183227
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
AP61559160
WA
Other
Enumeration date
09/01/2021
Last updated
09/27/2024
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