Organization Active NPI

Vavra Anesthesia Service Inc

  • Certified Registered Nurse Anesthetist
  • Sammamish, WA
National Provider Identifier
1821347949
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP30005421 Issued in WA
Legal business name
VAVRA ANESTHESIA SERVICE INC
Practice address
21453 SE 35TH Way
Sammamish, WA 98075-6240
Phone
(425) 392-8803
Fax
(425) 392-8944
NPI assigned
Sep 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Authorized official

Name
Mr. Jeffrey D. Vavra, CRNA
Title
President
Phone
(425) 392-8803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X AP30005421 WA Primary

Addresses

Primary practice location

21453 SE 35TH Way
Sammamish, WA 98075-6240

Mailing address

PO Box 1024
Issaquah, WA 98027-0039
Phone (425) 392-8803

Other identifiers 2

IdentifierTypeStateIssuer
VA6228OtherREGENCE
108803OtherWALABOR & INDUSTRIES

National Provider Directory

National Provider Directory

Locations

22525 SE 64th Pl
Ste 220
Issaquah, WA 98027

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1821347949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1024",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980270039",
            "telephone_number": "425-392-8803",
            "fax_number": "425-392-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21453 SE 35TH WAY",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980756240",
            "telephone_number": "425-392-8803",
            "fax_number": "425-392-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAVRA ANESTHESIA SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "VAVRA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-392-8803",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30005421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "VA6228",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "108803",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sammamish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.