Provider Demographics
NPI:1063480374
Name:BAUERNFEIND, TODD W (CRNA)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:W
Last Name:BAUERNFEIND
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:601 W 5TH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2715
Mailing Address - Country:US
Mailing Address - Phone:509-344-2663
Mailing Address - Fax:509-624-9179
Practice Address - Street 1:601 W 5TH AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2756
Practice Address - Country:US
Practice Address - Phone:509-344-2663
Practice Address - Fax:509-624-9179
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WARN00126402367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9544BAOtherASURIS NW HEALTH
WAP00130913OtherRR MEDICARE
WA192439200OtherOWCP
MT4303897Medicaid
ID000010147512OtherREGENCE BLUE SHIELD OF ID
WA9623166Medicaid
WA0185165OtherDEPT OF LABOR & INDUSTRIE
WA28402OtherGROUP HEALTH NW
ID805290000Medicaid
WA8938960OtherCRIME VICTIMS