Individual
KRISTEN MARIE ENGSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
10800 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-7758
(503) 652-2880
Mailing address
408 W VENETO CIR, MEDFORD, OR 97504-3625
(402) 214-8946
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201341218RN
OR
163W00000X
Registered Nurse
66482
NE
367500000X
Certified Registered Nurse Anesthetist
Primary
201360040CRNA
OR
Other
Enumeration date
07/09/2013
Last updated
05/11/2016
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