Individual
GLEN E. CARLSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-2235
Mailing address
MADIGAN ARMY MEDICAL CENTER, 9040 REID ST., TACOMA, WA 98431-0001
(253) 968-2252
(253) 968-3278
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30008038
WA
367500000X
Certified Registered Nurse Anesthetist
AP30008038
WV
Other
Enumeration date
10/22/2007
Last updated
07/12/2019
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