Provider Demographics
NPI:1265682264
Name:SILLS, LOLENA JILL (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LOLENA
Middle Name:JILL
Last Name:SILLS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:ANESTHESIA DEPARTMENT, B2-AN
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-223-6600
Mailing Address - Fax:206-223-6982
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:ANESTHESIA DEPARTMENT, B2-AN
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6600
Practice Address - Fax:206-223-6982
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN 00146622367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9661745Medicaid
WARNA0097OtherAK DSHS
WAP00786363OtherRAILROAD MEDICARE
WAP00786363OtherRAILROAD MEDICARE