Individual
MY LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1700 13TH ST, EVERETT, WA 98201-1689
(425) 261-2000
Mailing address
1102 OLYMPIC CT, OAK HARBOR, WA 98277-3301
(858) 699-7042
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9330924
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
152475
WA
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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