Provider Demographics
NPI:1629367370
Name:SIEBERT, TRISHA (CRNA)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:SIEBERT
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 94406
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-6706
Mailing Address - Country:US
Mailing Address - Phone:509-838-1547
Mailing Address - Fax:509-835-4058
Practice Address - Street 1:104 W 5TH AVE
Practice Address - Street 2:SUITE 250E
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4880
Practice Address - Country:US
Practice Address - Phone:509-838-1547
Practice Address - Fax:509-835-4058
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACRNA086657367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered