Individual
TRACI LYNN PRAYNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3010
(360) 740-1987
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3008
(608) 077-6873
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
0001171560
VA
367500000X
Certified Registered Nurse Anesthetist
55608
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60134098
WA
367500000X
Certified Registered Nurse Anesthetist
TEMPORARY
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0292062
LABOR AND INDUSTRY
WA
01
—
145946
BCBS
KS
05
—
1841369899
—
ID
05
—
1841369899
—
WA
05
—
200440240A
—
KS
05
—
500839464
—
OR
Enumeration date
11/06/2006
Last updated
09/05/2024
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