Individual
DAVID TERRAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-7641
Mailing address
3181 SW SAM JACKSON PARK RD # SJH-2, PORTLAND, OR 97239-3098
(503) 494-7641
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
202004533
OR
367500000X
Certified Registered Nurse Anesthetist
60656552
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063868479
—
WA
Enumeration date
05/05/2016
Last updated
06/09/2020
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