Individual
BRIAN N NORDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
801 E WHEELER RD, MOSES LAKE, WA 98837-1820
(509) 765-5606
Mailing address
660 S COOLIDGE ST, MOSES LAKE, WA 98837-1872
(509) 793-9715
(509) 764-3244
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
7725758
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30007782
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1044563
—
WA
01
—
134895100
FIRSTCARE COMMERCIAL
TX
05
—
134895101
—
TX
05
—
180399101
—
TX
05
—
200077930A
—
OK
01
—
202005544
PRESBYTERIAN COMMERCIAL
NM
05
—
202005544
—
NM
05
—
59223766
—
NM
01
—
86228U
BC/BS
TX
01
—
86243U
HMO BLUE
TX
Enumeration date
07/12/2006
Last updated
11/18/2022
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