Provider Demographics
NPI:1851519300
Name:OLYMPIC ANESTHESIA PC
Entity Type:Organization
Organization Name:OLYMPIC ANESTHESIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANH
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-597-4641
Mailing Address - Street 1:12359 SUNRISE VALLEY DR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3462
Mailing Address - Country:US
Mailing Address - Phone:703-597-4641
Mailing Address - Fax:703-991-8761
Practice Address - Street 1:12359 SUNRISE VALLEY DR
Practice Address - Street 2:SUITE 330
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3462
Practice Address - Country:US
Practice Address - Phone:703-597-4641
Practice Address - Fax:703-991-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052271207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty