Provider Demographics
NPI:1861679797
Name:LOCAL ANESTHESIA INCORPORATED
Entity Type:Organization
Organization Name:LOCAL ANESTHESIA INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:509-710-2545
Mailing Address - Street 1:1818 W FRANCIS AVE # 213
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6834
Mailing Address - Country:US
Mailing Address - Phone:509-465-1638
Mailing Address - Fax:509-465-8757
Practice Address - Street 1:123 W FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6364
Practice Address - Country:US
Practice Address - Phone:509-483-9363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004424367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA107659OtherLABOR AND INDUSTRIES
WA9617333Medicaid
WASM7243OtherASURIS
WA430029997OtherRAIL ROAD MEDICARE
WASM7243OtherASURIS