Individual
MR. LENNY EUGENE DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
342 FAIRVIEW STREET, SILVERTON, OR 97381
(503) 873-1705
(503) 873-1717
Mailing address
PO BOX 278, WOODBURN, OR 97071
(971) 983-5260
(971) 983-5326
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201041932RN
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
201701462CRNA
OR
Other
Enumeration date
10/02/2014
Last updated
07/21/2022
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