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Individual

KENNETH GANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
603 S CHESTNUT ST, ELLENSBURG, WA 98926-3875
(509) 962-9841
Mailing address
PO BOX 2385, IDAHO FALLS, ID 83403-2385
(208) 525-2090
(208) 523-8978

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30002572
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9635418
WA
Enumeration date
11/16/2006
Last updated
07/06/2021
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