Individual ProviderCalvin MulyadiNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1100 9th Ave, Seattle, WA 98101-2756(206) 223-6980PECOS EnrollmentBased on the most recent information from CMS, provider Calvin Mulyadi does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1134897317Provider TypeIndividualFull NameMulyadi, CalvinCredentialCRNAGenderMaleSole ProprietorYesEnumeration Date9/1/2021Last Updated9/27/2024Contact InformationPractice LocationPractice Address1100 9th Ave, Seattle, WA 98101-2756Phone(206) 223-6980Fax(206) 223-6982Mailing LocationMailing Address1100 9th Ave, Seattle, WA 98101-2756Phone(206) 223-6980Fax(206) 223-6982Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP61559160WashingtonCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense1-183227Alabama