Active NPI
Robert Allen Mildes, CRNA
- Certified Registered Nurse Anesthetist
- Lynnwood, WA
National Provider Identifier
1417994377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 025804 30004423
- Practice address
- 708 212TH PL SW
Lynnwood, WA 98036-8606 - Phone
- (425) 672-7275
- Fax
- (425) 744-0117
- NPI assigned
- Jun 1, 2006
- Last updated
- Jan 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 025804 30004423 | WA | Primary |
Addresses
Primary practice location
708 212TH PL SW
Lynnwood, WA 98036-8606
Mailing address
708 212TH PL SW
Lynnwood, WA 98036-8606
Phone (425) 672-7275
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)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025804 30004423 | WA | MD | Certified Registered Nurse Anesthetist |
Organizations & group practices 1
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.
-
- Certified Registered Nurse Anesthetist
- Lynnwood, WA
- NPI 1851599559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200009600000",
"number": "1417994377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 212TH PL SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980368606",
"telephone_number": "425-672-7275",
"fax_number": "425-744-0117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 212TH PL SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980368606",
"telephone_number": "425-672-7275",
"fax_number": "425-744-0117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILDES",
"first_name": "ROBERT",
"middle_name": "ALLEN",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2008-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "025804 30004423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.