Provider Demographics
NPI:1558398867
Name:VANDERWERFF, DOWIE J (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DOWIE
Middle Name:J
Last Name:VANDERWERFF
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 ROAD 13
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401-9563
Mailing Address - Country:US
Mailing Address - Phone:307-388-0108
Mailing Address - Fax:
Practice Address - Street 1:400 S 15TH ST
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401-3531
Practice Address - Country:US
Practice Address - Phone:307-347-5723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY27722.1028367500000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered