Provider Demographics
NPI:1548726615
Name:LIGAD, PAUL KEVIN (CRNA, ARNP)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:KEVIN
Last Name:LIGAD
Suffix:
Gender:M
Credentials:CRNA, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 14TH AVE UNIT 516
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4248
Mailing Address - Country:US
Mailing Address - Phone:407-873-2487
Mailing Address - Fax:
Practice Address - Street 1:201 16TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5226
Practice Address - Country:US
Practice Address - Phone:206-326-3000
Practice Address - Fax:206-326-3284
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9326955163W00000X
WAAP60981192367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9326955OtherREGISTERED NURSE