Organization
SUNDANCE ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI WAGNER CRNA (OWNER)
(509) 926-1770
Entity
Organization
Contact information
Practice address
6002 S YALE RD, SPOKANE, WA 99223-1744
(509) 990-5997
(509) 228-9542
Mailing address
6002 S YALE RD, SPOKANE, WA 99223-1744
(509) 990-5997
(509) 228-9542
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP60097099
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
01/17/2023
Last updated
01/17/2023
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