Individual
ROBERT W MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-8368
Mailing address
3181 SW SAM JACKSON PARK RD # 2, PORTLAND, OR 97239-3011
(503) 494-4910
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN167051
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
201402450CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
88013
TN
Other
Enumeration date
12/19/2011
Last updated
02/07/2020
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