Active NPI
Paul Kurtis Anderson, CRNA
- Certified Registered Nurse Anesthetist
- Chehalis, WA
National Provider Identifier
1952304198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP30006991
- Practice address
- 2517 NE Kresky Ave
Chehalis, WA 98532-2409 - Phone
- (360) 748-8632
- Fax
- (360) 748-3869
- NPI assigned
- May 23, 2005
- Last updated
- Dec 3, 2009
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704156636 | MI | |
| Certified Registered Nurse Anesthetist | 367500000X | AP30006991 | WA | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 169824 | CO | |
| Certified Registered Nurse Anesthetist | 367500000X | 31912 | MT | |
| Certified Registered Nurse Anesthetist | 367500000X | 200560026CRNA | OR | |
| Certified Registered Nurse Anesthetist | 367500000X | RNA-643 | ID | |
| Certified Registered Nurse Anesthetist | 367500000X | 278 | AK |
Addresses
Primary practice location
2517 NE Kresky Ave
Chehalis, WA 98532-2409
Mailing address
7210 188TH Street CT E
Puyallup, WA 98375-2424
Phone (253) 210-3541
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00349024 | Other | MT | RAILROAD MEDICARE |
| P00249398 | Other | WA | RAILROAD MEDICARE |
| P00390773 | Other | WA | RAILROAD MEDICARE |
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 |
|---|---|---|---|
| 278 | AK | MD | Optician |
| 169824 | CO | MD | Certified Registered Nurse Anesthetist |
| RNA-643 | ID | MD | Certified Registered Nurse Anesthetist |
| 4704156636 | MI | MD | Certified Registered Nurse Anesthetist |
| 31912 | MT | MD | Certified Registered Nurse Anesthetist |
| 200560026CRNA | OR | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Cataract and Laser Institute, Inc., P.C. | Past | Accepting new patients |
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.
-
- Ophthalmologic Surgery Clinic/Center
- Auburn, WA
- NPI 1528814647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259798400000",
"number": "1952304198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7210 188TH STREET CT E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983752424",
"telephone_number": "253-210-3541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2517 NE KRESKY AVE",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985322409",
"telephone_number": "360-748-8632",
"fax_number": "360-748-3869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "PAUL",
"middle_name": "KURTIS",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-23",
"last_updated": "2009-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704156636",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP30006991",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CO",
"license": "169824",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MT",
"license": "31912",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OR",
"license": "200560026CRNA",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ID",
"license": "RNA-643",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AK",
"license": "278",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00349024",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00249398",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00390773",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.