Kittitas Anesthesia LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

KITTITAS ANESTHESIA LLC

Practice address

603 S Chestnut St
Ellensburg, WA 98926-3875

Phone

(509) 962-9841

Fax

(509) 962-7413

NPI assigned

Jan 12, 2021

Organization subpart

No

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

Authorized official

Name

Dalila Fairchild, CRNA

Title

President

Phone

(208) 525-2090

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1427647643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2385",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032385",
            "telephone_number": "208-525-2090",
            "fax_number": "208-523-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S CHESTNUT ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263875",
            "telephone_number": "509-962-9841",
            "fax_number": "509-962-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITTITAS ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "FAIRCHILD",
        "authorized_official_first_name": "DALILA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-525-2090",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Kilts, M. ED.
• Heesue Kim, RPH
• Jin Ah Kim, PHARM.D.
• Samuel Kim
• Chadrick Halston Kirkpatrick
• Kittitas County Fire Protection District 2
• Kittitas County Public Health
• Kittitas County Public Health
• Kittitas County Public Hosp Dist 1
• Kittitas County Public Hosp Dist 1

• All providers in Ellensburg, WA
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.