Provider Demographics
NPI:1942442306
Name:GARRETT, TODD R (CRNA)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:R
Last Name:GARRETT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 MT ST HELENS CT
Mailing Address - Street 2:
Mailing Address - City:WEST RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99353-6751
Mailing Address - Country:US
Mailing Address - Phone:509-520-3585
Mailing Address - Fax:
Practice Address - Street 1:3304 MT ST HELENS CT
Practice Address - Street 2:
Practice Address - City:WEST RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99353-6751
Practice Address - Country:US
Practice Address - Phone:509-520-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60297382367500000X
MTNURAPRNLIC101154367500000X
IDAPRNCRNA58815367500000X
SDR035503367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered