Organization
PACELINE ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN E SIAPCO CRNA (OWNER/PROVIDER)
(253) 588-7911
Entity
Organization
Contact information
Practice address
3819 100TH ST SW, SUITE 7-C, LAKEWOOD, WA 98499-4470
(253) 588-7911
(253) 984-6774
Mailing address
2100 LITTLE MT LANE, MOUNT VERNON, WA 98274
(360) 416-6735
(360) 424-6924
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AP30006883
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9656489
—
WA
Enumeration date
09/12/2008
Last updated
09/12/2008
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