Individual
MR. BRUCE EVAN KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA MSN
Contact information
Practice address
5633 N LIDGERWOOD, SPOKANE, WA 99208
(509) 482-0111
Mailing address
5633 N LIDGERWOOD, SPOKANE, WA 99208
(509) 482-0111
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30007302
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP30007302
STATE LICENSE
WA
01
—
RN00163452
STATE LICENSE
WA
05
—
RN3329700
—
CA
Enumeration date
01/11/2006
Last updated
05/29/2009
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