Provider Demographics
NPI:1275933962
Name:ALLY ANESTHESIA SERVICES PLLC
Entity Type:Organization
Organization Name:ALLY ANESTHESIA SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RAELYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RAVER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA, MSN
Authorized Official - Phone:206-384-2087
Mailing Address - Street 1:PO BOX 77717
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-0717
Mailing Address - Country:US
Mailing Address - Phone:206-384-2087
Mailing Address - Fax:
Practice Address - Street 1:914 N 70TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5335
Practice Address - Country:US
Practice Address - Phone:206-384-2087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty