Individual
MICHAEL R ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-3131
Mailing address
1812 S CLOVER DR, SPOKANE VALLEY, WA 99016-5081
(801) 372-0354
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
000265583
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
151833
WA
Other
Enumeration date
08/26/2024
Last updated
10/07/2024
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