Organization
SUNSTONE ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA L JOHNSON CRNA (PRESIDENT)
(503) 702-0189
Entity
Organization
Contact information
Practice address
12538 SW 134TH AVE, TIGARD, OR 97223-4721
(888) 209-0305
(952) 442-3620
Mailing address
400 10TH ST E, WACONIA, MN 55387-4552
(888) 209-0305
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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