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Individual

MS. PEGGY M ENDRES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
5633 N LIDGERWOOD ST, SPOKANE, WA 99208-1224
(509) 482-2359
Mailing address
3924 S EASTGATE CT, SPOKANE, WA 99203-1413
(509) 456-4553

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30004679
WA
367500000X
Certified Registered Nurse Anesthetist
RNA-670
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8053187
IDAHO PROVIDER NUMBER
ID
Enumeration date
05/04/2007
Last updated
07/08/2007
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