Provider Demographics
NPI:1437111663
Name:MAY, JANICE IRENE (CRNA)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:IRENE
Last Name:MAY
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:PO BOX 577
Mailing Address - Street 2:507 HOSPITAL WAY
Mailing Address - City:BREWSTER
Mailing Address - State:WA
Mailing Address - Zip Code:98812-0577
Mailing Address - Country:US
Mailing Address - Phone:509-689-2517
Mailing Address - Fax:509-689-2086
Practice Address - Street 1:507 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:WA
Practice Address - Zip Code:98812-0577
Practice Address - Country:US
Practice Address - Phone:509-689-2517
Practice Address - Fax:509-689-2086
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005355367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9609967Medicaid
WAGAB23043Medicare ID - Type Unspecified
WAF20970Medicare UPIN