Individual
JEUDIEL R. PUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4260
(206) 598-8812
Mailing address
26323 NE 25TH ST, REDMOND, WA 98053-9081
(425) 213-9915
(425) 898-7105
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00156597
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30006800
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0191489
LABOR & INDUSTRY
WA
01
—
62103U
REGENCE BLUESHIELD
WA
01
—
8939758
L & I CRIME VICTIMS
WA
05
—
9642901
—
WA
Enumeration date
04/06/2006
Last updated
01/26/2012
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