Mr William G Chisholm Jr, CRNA is a
Nurse Anesthetist, Certified Registered based in Ilwaco, Washington. Mr William G Chisholm Jr is licensed to practice in Washington (license number AP30001327) and his current practice location is
174 1st Ave N, Ilwaco, Washington. He can be reached at his office (for appointments etc.) via phone at
(360) 642-3181.
NPI number for Mr William G Chisholm Jr is 1396775938 and his current mailing address is 91 E Tamarack Ln, Shelton, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1396775938.
Provider's Profile
| Full Name | Mr William G Chisholm Jr |
|---|
| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 174 1st Ave N, Ilwaco, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1396775938
- Provider Enumeration Date: 07/03/2006
- Last Update Date: 02/02/2016
Medical Identifiers
Medical identifiers for Mr William G Chisholm Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396775938 | NPI | - | NPPES |
| 210785 | Medicaid | OR | |
| 430073112 | Other | WA | MEDICARE RAILROAD |
| 9603887 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP30001327 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr William G Chisholm Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr William G Chisholm Jr, CRNA
91 E Tamarack Ln,
Shelton, WA 98584-9402
Ph: (360) 427-5747 | Mr William G Chisholm Jr, CRNA
174 1st Ave N,
Ilwaco, WA 98624-9137
Ph: (360) 642-3181 |
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