Provider Demographics
NPI:1750151056
Name:EPPICH, NATHAN (CRNA)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:EPPICH
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 1:3745 LOVELL RD
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-9169
Mailing Address - Country:US
Mailing Address - Phone:509-942-9333
Mailing Address - Fax:
Practice Address - Street 1:603 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3875
Practice Address - Country:US
Practice Address - Phone:509-962-9841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61516359207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty