Individual
DANA WOLAK DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 N 115TH ST, SEATTLE, WA 98133
(206) 364-0500
Mailing address
4125 50TH AVE S, SEATTLE, WA 98118-1234
(248) 250-3704
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201503625RN
OR
163W00000X
Registered Nurse
RN60454845
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60824100
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275901738
—
WA
Enumeration date
09/14/2015
Last updated
08/16/2018
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