NPIMap

Organization Active NPI

Ethereal Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Seattle, WA
National Provider Identifier
1942765359
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ETHEREAL ANESTHESIA PLLC
Practice address
9730 3Rd Ave NE Ste 200
Seattle, WA 98115-2023
Phone
(206) 985-9553
NPI assigned
Feb 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Authorized official

Name
Mr. Hunter Schulz, CRNANPI 1679014542
Title
President
Phone
(425) 269-6617

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

9730 3Rd Ave NE Ste 200
Seattle, WA 98115-2023

Mailing address

12047 NE 75TH St
Kirkland, WA 98033-8108
Phone (425) 269-6617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190318001499 WA Part B Supplier - Clinic/Group Practice 1759621329 Receives reassigned benefits from 12 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549843200000",
    "number": "1942765359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12047 NE 75TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980338108",
            "telephone_number": "425-269-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 3RD AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152023",
            "telephone_number": "206-985-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHEREAL ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A",
        "authorized_official_last_name": "SCHULZ",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-269-6617",
        "authorized_official_name_prefix": "Mr.",
        "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": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.