Provider Demographics
NPI:1003926304
Name:INLAND ANESTHESIA SERVICES P S
Entity Type:Organization
Organization Name:INLAND ANESTHESIA SERVICES P S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANDREGG
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:509-991-6992
Mailing Address - Street 1:9906 S SILVER LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-5044
Mailing Address - Country:US
Mailing Address - Phone:509-991-6992
Mailing Address - Fax:509-228-9542
Practice Address - Street 1:535 S PINE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1347
Practice Address - Country:US
Practice Address - Phone:509-991-6992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9615964Medicaid
WA=========OtherTAX ID
WA=========OtherTAX ID