Provider Demographics
NPI:1356345185
Name:BUONORA, JOHN E (CRNA)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:E
Last Name:BUONORA
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10901 102ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-2909
Mailing Address - Country:US
Mailing Address - Phone:240-429-8870
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-4933
Practice Address - Country:US
Practice Address - Phone:253-968-0554
Practice Address - Fax:253-986-3278
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI133435-030367500000X
WAAP60879305367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2141668Medicaid
WI43388700Medicaid