Individual
TIMOTHY RICHARD ENTZEROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2811 TIETON DR, YAKIMA, WA 98902-3761
(509) 575-8000
Mailing address
7404 SADDLEBROOK LOOP, YAKIMA, WA 98908-5909
(636) 288-6279
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
133972
MO
Other
Enumeration date
07/02/2021
Last updated
07/02/2021
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