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Rodney F Hestdalen

Anesthesiology

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as RODNEY HESTDALEN.

Based on the most recent information from CMS, provider Rodney F Hestdalen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1144345596
Provider Type
Individual
Full Name
Hestdalen, Rodney F
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/21/2007
Last Updated
3/27/2015

Contact Information

Practice Location

101 W 8th Ave, Spokane, WA 99204-2307

(509) 474-3131

Unlisted Fax

Mailing Location

PO Box 94645, Seattle, WA 98124-6945

(509) 474-3131

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License MD00040223 Washington

Provider Identifiers

ID	Description	Issuer
ID 8310245	Description Medicaid	Issuer Unlisted Washington

Rodney F Hestdalen

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Wolf, Scott William

Pierce, Trenton L

Kass, Thomas

Dhulst, Daniel Matthew

Simpson, David Scott

Burgan, Jeffrey

Eichner, Jesse Daniel

Taylor, Jordan M.

Rietze, Stacey Alan

Konovsky, Don J