Individual
MR. CHARLES JOSEPH PARADISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1333 E BARNETT RD, MEDFORD, OR 97504-8219
(541) 779-4711
(541) 779-0796
Mailing address
1333 E BARNETT RD, MEDFORD, OR 97504-8219
(361) 883-6211
(361) 882-4891
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
202002199CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
691160
TX
Other
Enumeration date
10/25/2005
Last updated
07/31/2020
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