Individual
EDWARD R WINTERBOTTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
835 SE BISHOP BLVD, PULLMAN, WA 99163-5512
(509) 332-2541
Mailing address
PO BOX 487, PULLMAN, WA 99163-0487
(509) 332-4051
(509) 332-4051
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30005207
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
911603497
TAX ID
WA
05
—
9609629
—
WA
Enumeration date
08/30/2006
Last updated
07/08/2007
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