Individual
KENNETH CUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
514 NW 49TH ST, VANCOUVER, WA 98663-1211
(360) 936-8638
Mailing address
514 NW 49TH ST, VANCOUVER, WA 98663-1211
(360) 936-8638
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60332822
WA
367500000X
Certified Registered Nurse Anesthetist
D119508
IA
367500000X
Certified Registered Nurse Anesthetist
RN195823 CRNA
GA
Other
Enumeration date
03/18/2008
Last updated
07/13/2015
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