Organization
THREE RIVERS ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERN A. KOSTENKO CRNA (AUTHORIZED SIGNER)
(503) 372-2740
Entity
Organization
Contact information
Practice address
900 S AUBURN ST, KENNEWICK, WA 99336-5621
(509) 586-5840
Mailing address
PO BOX 34940, SEATTLE, WA 98124-1940
(503) 372-2740
(503) 372-2754
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7125453
—
WA
Enumeration date
05/05/2006
Last updated
11/20/2007
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