Provider Demographics
NPI:1821172537
Name:STRAND, ROGER A (CRNA)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:A
Last Name:STRAND
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 1:203 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:TONASKET
Mailing Address - State:WA
Mailing Address - Zip Code:98855-8803
Mailing Address - Country:US
Mailing Address - Phone:509-486-2151
Mailing Address - Fax:
Practice Address - Street 1:734 N 190TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3909
Practice Address - Country:US
Practice Address - Phone:206-542-4878
Practice Address - Fax:206-542-4878
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003856367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered