AMNESIA LLC (NPI# 1922202688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922202688 |
| Entity Type | Organization |
| Organization Name | AMNESIA LLC |
| Practice Address |
4717 S 19th St Tacoma WA 98405-1167 |
| Mailing Address |
3819 100th St Sw Suite 7c Lakewood WA 98499-4470 |
| Practice Telephone | 2537610861 |
| Mailing Telephone | 2535887911 |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BROCK M SMITH (OWNER) |
| Authorized Official Telephone | 3607533516 |
| Authorized Official Credential | CRNA, ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 9652017 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | AMNESIA LLC | 8326 Jamieson Court Sw, Tumwater, WA 98512 |
| Oklahoma Business Registrations | AMNESIA LLC | 917 W Britton, Oklahoma City, OK 73145 |
| Street Address |
4717 S 19TH ST |
| City | TACOMA |
| State | WA |
| Zip Code | 98405-1167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891722609 | Eye Mds of Puget Sound Pllc | Clinic/Center | 4717 S 19th St, Ste 10, Tacoma, WA 98405-1167 | 2006-06-27 |
| 1659822047 | Young Men's Christian Association of Pierce and Kitsap Counties | Health Educator | 4717 S 19th St, #201, Tacoma, WA 98405-1167 | 2016-10-20 |
| 1417265760 | Inspire Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 4717 S 19th St, Tacoma, WA 98405-1167 | 2010-09-21 |
| 1982897997 | Barbara H Klube Crna Ps | Anesthesiology | 4717 S 19th St, Tacoma, WA 98405-1167 | 2007-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
| 1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| Find all providers in zip 98405 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699068106 | Jake Michael Burnbaum | Anesthesiology | 314 Mlk Jr. Way, Suite 300, Tacoma, WA 98405 | 2011-05-17 |
| 1780900142 | Elbert Chang | Anesthesiology | 314 Martin Luther King Jr Way Ste 300, Tacoma, WA 98405-4292 | 2010-04-10 |
| 1568787786 | Thuydung Thi Trinh | Anesthesiology | 314 M L King Jr Way Ste 300, Tacoma, WA 98405-4292 | 2010-03-30 |
| 1033378054 | Adam David Demars | Anesthesiology | 1102 A St Unit 1536, Tacoma, WA 98401-1210 | 2008-06-05 |
| 1043413792 | Amanda M Fern | Anesthesiology | 3302 N 19th St, Tacoma, WA 98406-6007 | 2007-06-08 |
| 1700978327 | James Russell Lee | Anesthesiology | Dept of Anesthesia and Operative Services, Madigan Army Medical Center, Tacoma, WA 98431-5000 | 2006-09-29 |
| 1760588099 | Matthew James Shiveley | Anesthesiology | 1313 Broadway Plaza, Ste 200, Tacoma, WA 98402-3400 | 2006-09-15 |
| 1396750725 | David N. Desertspring | Anesthesiology | 1901 S. Union Avenue, Allenmore Hospital & Medical Center, Tacoma, WA 98405 | 2006-07-31 |
| 1568497303 | Michael Dean Scarbrough | Anesthesiology | 624 N Yakima Ave, Tacoma, WA 98403-2418 | 2006-07-11 |
| 1578594081 | Steven M Berger | Anesthesiology | 1718 South J. Street, Tacoma, WA 98401 | 2006-07-05 |
| Find all providers in TACOMA | ||||
Please comment or provide details below to improve the information on AMNESIA LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.