Amos, Brock J

Amos, Brock J is an individual health care provider with primary practice located at 1615 Delaware St , Longview WA 98632-2367. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Amos, Brock J can be contacted via phone (360) 414-2000.

Contact Information

Primary practice address
1615 Delaware St Longview WA 98632-2367
Phone: (360) 414-2000
Fax: (360) 414-7638
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP60410232 Washington

Profile Details

NPI number 1295807717
LBN Legal business name Amos, Brock J
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Feb 15th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295807717 NPPES
Washington MEDICAID 2038923
Washington MEDICAID G8937842

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