Organization
PULLMAN ANESTHESIA ASSOCIATES PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY D JOHNSON CRNA (PRESIDENT)
(509) 413-3147
Entity
Organization
Contact information
Practice address
835 SE BISHOP BLVD, PULLMAN, WA 99163-5512
(509) 413-3147
Mailing address
PO BOX 29650, DEPT # 880129, PHOENIX, AZ 85038-9650
(509) 413-3147
(509) 336-7599
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9609173
—
WA
Enumeration date
08/30/2006
Last updated
05/16/2016
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