# PREMIER ANESTHESIA OF OREGON PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154010429
- **Authorized official:** RANDY WALKER (VP FINANCE)
- **Authorized official phone:** (678) 690-7812

## Contact information

- **Practice address:** 1001 N PROVIDENCE DR, NEWBERG, OR 97132-7485
- **Practice address phone:** (678) 690-7816
- **Mailing address:** 2655 NORTHWINDS PKWY, ALPHARETTA, GA 30009-2280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |

## Other

- **Enumeration date:** 05/03/2023
- **Last updated:** 05/03/2023