Provider Demographics
NPI:1356694244
Name:PRINCE, JAMES CARLTON III (CRNA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CARLTON
Last Name:PRINCE
Suffix:III
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1229 MADISON ST
Mailing Address - Street 2:STE 1440
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3538
Mailing Address - Country:US
Mailing Address - Phone:206-625-0578
Mailing Address - Fax:206-625-9184
Practice Address - Street 1:1229 MADISON ST
Practice Address - Street 2:STE 1440
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3538
Practice Address - Country:US
Practice Address - Phone:206-625-0578
Practice Address - Fax:206-625-9184
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2023-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLRN9236268163W00000X
MA2282711163W00000X, 367500000X
WAAP60616023367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse