Provider Demographics
NPI:1891701793
Name:MURRAY, JOSEPH P (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:MURRAY
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:PO BOX 487
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-0487
Mailing Address - Country:US
Mailing Address - Phone:509-332-4051
Mailing Address - Fax:509-332-4051
Practice Address - Street 1:1630 23RD AVE STE 901B
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-6353
Practice Address - Country:US
Practice Address - Phone:208-298-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRNA-416367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered