Individual
CHARLES ROESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3043 NE 28TH STREET, LINCOLN CITY, OR 97367-4518
(541) 996-7152
(541) 996-7180
Mailing address
PO BOX 1194, CORVALLIS, OR 97339-1194
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200841321RN
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
201603514CRNA
OR
Other
Enumeration date
03/24/2016
Last updated
04/30/2021
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