Individual
LEA SEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2700 SE STRATUS AVE, MCMINNVILLE, OR 97128-8872
(503) 435-6580
Mailing address
2700 SE STRATUS AVE, MCMINNVILLE, OR 97128-8872
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
201160032CRNA
OR
Other
Enumeration date
01/10/2008
Last updated
07/26/2011
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