Individual
PATRICIA W VANDERWILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1414 N HOUK RD, STE 204, SPOKANE VALLEY, WA 99216-1097
(509) 922-0362
(509) 228-9542
Mailing address
PO BOX 94645, SEATTLE, WA 98124-6945
(509) 474-3181
(706) 650-1034
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30006179
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9639071
—
WA
Enumeration date
03/30/2006
Last updated
05/01/2018
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