Michael Magennis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP30005199 Issued in WA

Practice address

1015 E 'D' Street
Deer Park, WA 99006-0742

Phone

(509) 276-5061

NPI assigned

Dec 13, 2006

Last updated

Dec 10, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services - Washington

  dba Providence Holy Family Hospital

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1083866453
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1043372675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 N WASHINGTON ST",
            "address_2": "SUITE 209",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012202",
            "telephone_number": "509-232-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 E 'D' STREET",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990060742",
            "telephone_number": "509-276-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGENNIS",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30005199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9617507",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen M Laughlin, PA-C
• Living Path Counseling LLC
• Lori Tetsuro McDonald (Hearing Center of Deer Park LLC)
• Kendahl Ann Ludiker, PA
• Carey Ann Mack, PT
• Mahanaim Psychology Services, PLLC
• Jeremy Kyle Marcuson, O.D.
• Melissa Ann McCollough, LMP
• Lori T McDonald, HIS, AAS
• Jennifer L McLaughlin, LMT

• Certified Registered Nurse Anesthetist in Deer Park, WA
• Providers in Deer Park, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.