Individual
KENNETH RIEBELING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1374
Mailing address
85463 SVARVERUD RD, EUGENE, OR 97405-9427
(541) 756-6301
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
093006155
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032512
AANA
OR
01
—
093006155
RN/CRNA
OR
05
—
182724
—
OR
01
—
P00228431
RAILROAD MEDICARE
OR
Enumeration date
07/17/2006
Last updated
06/30/2008
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