Provider Demographics
NPI:1699786368
Name:KROLL, JAMES ALLAN (CRNA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALLAN
Last Name:KROLL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2029 161ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:SNOKOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-7771
Mailing Address - Country:US
Mailing Address - Phone:206-654-9025
Mailing Address - Fax:475-397-8257
Practice Address - Street 1:1600 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:425-454-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004363367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0063386OtherL & I
WA9605668Medicaid
WAKR4632OtherKCMBS