Provider Demographics
NPI:1366105652
Name:LUTHER, MEGAN (CRNA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LUTHER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3306 N 26TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-6237
Mailing Address - Country:US
Mailing Address - Phone:480-993-4835
Mailing Address - Fax:
Practice Address - Street 1:990 SYLVAN WAY STE 101
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2851
Practice Address - Country:US
Practice Address - Phone:360-479-3657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61216988367500000X
TXAP1156022367500000X
WAAP61216988207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology