THEODORE RUSSELL GAVEL

CENTRALIA, WA
NPI1134448996
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: WA  AP60443744)
Additional Taxonomies367500000X Nurse Anesthetist, Certified Registered
(Licence: PA  RN584062)
Enumeration Date2010-05-19
Last Update Date2014-05-21
Business Address
-- THEODORE RUSSELL GAVEL CRNA
914 S SCHEUBER RD PMG SW WA CENTRALIA ANESTHESIOLOGY
CENTRALIA, WA 98531-9027
Phone number: 360-736-2803
Mailing Address
-- THEODORE RUSSELL GAVEL CRNA
PO BOX 3360
PORTLAND, OR 97208-3360
Phone number: 866-747-2455
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