Four Creeks Anesthesia Services LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP30007351 Issued in WA

Legal business name

FOUR CREEKS ANESTHESIA SERVICES LLC

Practice address

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

Phone

(206) 985-9553

Fax

(206) 985-9806

NPI assigned

Jun 24, 2009

Organization subpart

No

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

Authorized official

Name

Loren K Copeland, CRNA

Title

Provider/Owner

Phone

(425) 614-8124

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1982832333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97115",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984970115",
            "telephone_number": "253-588-7911",
            "fax_number": "253-365-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 3RD AVE NE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152023",
            "telephone_number": "206-985-9553",
            "fax_number": "206-985-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CREEKS ANESTHESIA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "COPELAND",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "425-614-8124",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30007351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN00163428 RN LICENSE",
            "identifier": "AP30007351",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bo Foulks
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• Susan O. Fouts, LICSW
• Kennedy Olivia Fowle, LCSW

• Certified Registered Nurse Anesthetist in Seattle, WA
• Providers in Seattle, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.