Individual
MATTHEW MINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-2072
Mailing address
PO BOX 94645, SEATTLE, WA 98124-6945
(509) 474-2072
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
071445
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60025710
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NAN550
—
SC
Enumeration date
05/12/2006
Last updated
11/24/2014
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