Provider Demographics
NPI:1750348876
Name:RIMPLER, MICHAEL LEE (CRNA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LEE
Last Name:RIMPLER
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 1:411 FORTUYN RD
Mailing Address - Street 2:
Mailing Address - City:GRAND COULEE
Mailing Address - State:WA
Mailing Address - Zip Code:99133
Mailing Address - Country:US
Mailing Address - Phone:509-633-1753
Mailing Address - Fax:509-633-1930
Practice Address - Street 1:411 FORTUYN RD
Practice Address - Street 2:
Practice Address - City:GRAND COULEE
Practice Address - State:WA
Practice Address - Zip Code:99133
Practice Address - Country:US
Practice Address - Phone:509-633-1753
Practice Address - Fax:509-633-1930
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARX00096226163W00000X
WAAP30003379367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8801363Medicare Oscar/Certification
R89187Medicare UPIN