Organization
VAVRA ANESTHESIA SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY D. VAVRA CRNA (PRESIDENT)
(425) 392-8803
Entity
Organization
Contact information
Practice address
21453 SE 35TH WAY, SAMMAMISH, WA 98075-6240
(425) 392-8803
(425) 392-8944
Mailing address
PO BOX 1024, ISSAQUAH, WA 98027-0039
(425) 392-8803
(425) 392-8944
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30005421
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108803
LABOR & INDUSTRIES
WA
01
—
VA6228
REGENCE
—
Enumeration date
09/05/2012
Last updated
09/05/2012
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