Individual
MICHAEL BRUCE LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-1110
Mailing address
9040 JACSON AVE, ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-1100
(532) 968-1110
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R30271
ND
163W00000X
Registered Nurse
RN 60183310
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP6027366
WA
Other
Enumeration date
01/10/2012
Last updated
04/30/2019
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