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Individual

FE M DEMIAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1016 TACOMA AVE, SUNNYSIDE, WA 98944
(509) 837-1500
Mailing address
PO BOX 2329, MOUNT VERNON, WA 98273-7329
(360) 466-2542
(360) 466-2682

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30005209
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0191200
DEPARTMENT OF LABOR AND INDUSTRIES
WA
01
4984DE
REGENCE BLUE SHIELD
WA
05
9629205
WA
01
P00224710
RAILROAD MEDICARE
WA
Enumeration date
11/17/2006
Last updated
05/22/2008
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