Provider Demographics
NPI:1245777267
Name:FAIRCHILD ANESTHESIA PLLC
Entity Type:Organization
Organization Name:FAIRCHILD ANESTHESIA PLLC
Other - Org Name:DALILA FAIRCHILD CRNA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALILA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIRCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:509-899-9083
Mailing Address - Street 1:5241 UMPTANUM RD
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-6989
Mailing Address - Country:US
Mailing Address - Phone:509-899-9083
Mailing Address - Fax:
Practice Address - Street 1:5241 UMPTANUM RD
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-6989
Practice Address - Country:US
Practice Address - Phone:509-899-9083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-28
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60292819367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty