Individual
MR. LYLE EDGAR GATES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
12606 E MISSION AVE, SPOKANE VALLEY, WA 99216-3421
(509) 473-5723
Mailing address
PO BOX 440, VALLEYFORD, WA 99036-0440
(509) 926-4329
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
09907743CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30001278
WA
367500000X
Certified Registered Nurse Anesthetist
RNA-488
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30129
L&I
WA
05
—
9607771
—
WA
05
—
9612367
—
WA
Enumeration date
07/07/2005
Last updated
08/24/2009
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