Provider Demographics
NPI:1538528682
Name:CAPITAL ANESTHESIA, LLC
Entity type:Organization
Organization Name:CAPITAL ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ANESTHESIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:C
Authorized Official - Last Name:ENGEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CRNA
Authorized Official - Phone:801-580-7868
Mailing Address - Street 1:4220 20TH LN NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8522
Mailing Address - Country:US
Mailing Address - Phone:801-580-7868
Mailing Address - Fax:
Practice Address - Street 1:4220 20TH LN NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8522
Practice Address - Country:US
Practice Address - Phone:801-580-7868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60308168367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty