Most Relevant Information
Provider Data
| NPI Number: | 1003406661 |
| Provider Name: | MATTHEW LIBID CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 61444170 |
Most Important Dates
| Enumeration Date: | 01/19/2021 |
| Last Updated: | 03/14/2024 |
Provider Practice Location
9040 JACKSON AVE
TACOMA
WA
984314292
Practice Location Phone/Fax
| Phone: | 2037685053 |
| Fax: |
Provider Mailing Location
9040 JACKSON AVE
TACOMA
WA
984310001
Provider Mailing Phone/Fax
| Phone: | 2037685053 |
| Fax: |