TIFFANY LEIGH GUNDERSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1184960767
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
512 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OR
Provider Addresses for TIFFANY LEIGH GUNDERSON (CRNA)
PO BOX 3330
SALT LAKE CITY, UT 841103330
Phone: (888) 333-1095
Type: Mailing
470 NE A ST
MADRAS, OR 977411844
Phone: (541) 475-3882
Type: Location
27809 N SPOTTED RD
DEER PARK, WA 990065102
Phone: (541) 706-1434
Type: Mailing
100 N MULLAN RD STE 204
SPOKANE VALLEY, WA 992066848
Phone: (509) 900-6300
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-08-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130424001003 | I | Certified Registered Nurse Anesthetist (Crna) | WA | TBD |
| I20210818001987 | I | Certified Registered Nurse Anesthetist (Crna) | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84110)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WA | |
| Pain Management, Anesthesiology | WA | |
| Pain Management, Anesthesiology, Anesthesiology | WA | |
| Physician Assistant | WA | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | WA | |
| Pain Management, Anesthesiology | WA | |
| Nurse Practitioner | WA |
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