Individual
MARY L MUENCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 PORT DR, CLARKSTON, WA 99403-1835
(509) 758-8811
(509) 751-1188
Mailing address
PO BOX 423, GRANGEVILLE, ID 83530
(208) 413-8744
(208) 983-1921
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
18343
ID
163W00000X
Registered Nurse
RN00084325
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30004075
WA
367500000X
Certified Registered Nurse Anesthetist
RNA-45A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8041095
—
ID
05
—
9635053
—
WA
Enumeration date
09/28/2006
Last updated
04/13/2017
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