Provider Demographics
NPI:1649957945
Name:PRECISION ANESTHESIA CARE PLLC
Entity type:Organization
Organization Name:PRECISION ANESTHESIA CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:808-255-4070
Mailing Address - Street 1:7902 E UHLIG RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-9759
Mailing Address - Country:US
Mailing Address - Phone:808-255-4070
Mailing Address - Fax:
Practice Address - Street 1:123 W FRANCIS AVE # 6348
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6348
Practice Address - Country:US
Practice Address - Phone:808-255-4070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty