Organization
SUMMIT ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER REX THORNOCK CRNA (MANAGER)
(435) 668-4334
Entity
Organization
Contact information
Practice address
6703 W RIO GRANDE AVE BLDG A, KENNEWICK, WA 99336-2623
(509) 946-9375
Mailing address
15205 S MOUNTAIN RIDGE CT, KENNEWICK, WA 99338-8325
14356684334
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
604089025
WA
Other
Enumeration date
09/22/2017
Last updated
03/17/2018
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