Provider Demographics
NPI:1073511515
Name:BOBIAK, DAVID JOHN (ARNP/CRNA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOHN
Last Name:BOBIAK
Suffix:
Gender:M
Credentials:ARNP/CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:990 SYLVAN WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-2851
Mailing Address - Country:US
Mailing Address - Phone:360-479-3657
Mailing Address - Fax:360-373-7616
Practice Address - Street 1:990 SYLVAN WAY
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2851
Practice Address - Country:US
Practice Address - Phone:360-479-3657
Practice Address - Fax:360-373-7616
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005417367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7215BOOtherREGENCE BLUE SHIELD
WA0159563OtherLABOR AND INDUSTRIES
WA910847215OtherTRIWEST
WA910847215OtherUNIFORM MEDICAL
WA016487001OtherGROUP HEALTH CORP
WA430070634OtherRAILROAD MEDICARE
WA910847215OtherPREMERA BLUE CROSS
WA910847215-33OtherKPS
WA9612557Medicaid
WAAB28206Medicare ID - Type UnspecifiedMEDICARE
WA910847215OtherUNIFORM MEDICAL