Individual provider Active NPI

Donna Margaret Funk, CRNA

  • Certified Registered Nurse Anesthetist
  • Olympia, WA
National Provider Identifier
1417250796
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
027975CRNARN00098041 Issued in WA
Practice address
3425 Ensign Rd. NE Suite 310
South Sound Oral Surgery Ensign Medical Center
Olympia, WA 98506
Phone
(360) 456-5678
Fax
(360) 456-1238
NPI assigned
Dec 8, 2010
Last updated
Dec 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 027975CRNARN00098041 WA Primary

Addresses

Primary practice location

3425 Ensign Rd. NE Suite 310
South Sound Oral Surgery Ensign Medical Center
Olympia, WA 98506

Mailing address

3425 Ensign Rd. NE Suite 310
South Sound Oral Surgery Ensign Medical Center
Olympia, WA 98506
Phone (360) 456-5678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
027975CRNARN00098041WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Oral Surgery PLLC Past Accepting new patients
South Sound Ambulatory Surgery Center, PLLC PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1417250796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 ENSIGN RD. NE SUITE 310",
            "address_2": "SOUTH SOUND ORAL SURGERY ENSIGN MEDICAL CENTER",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-456-5678",
            "fax_number": "360-456-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 ENSIGN RD. NE SUITE 310",
            "address_2": "SOUTH SOUND ORAL SURGERY ENSIGN MEDICAL CENTER",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-456-5678",
            "fax_number": "360-456-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "DONNA",
        "middle_name": "MARGARET",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "027975CRNARN00098041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; 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.