Provider Demographics
NPI:1710319785
Name:INLAND ANESTHESIA SERVICE
Entity Type:Organization
Organization Name:INLAND ANESTHESIA SERVICE
Other - Org Name:INLAND PAIN SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTANA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:509-362-9653
Mailing Address - Street 1:PO BOX 8654
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-0654
Mailing Address - Country:US
Mailing Address - Phone:509-362-9653
Mailing Address - Fax:509-362-9705
Practice Address - Street 1:507 S WASHINGTON ST STE 170
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2629
Practice Address - Country:US
Practice Address - Phone:509-362-9653
Practice Address - Fax:509-362-9705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRNA-777A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty