Individual
BENJAMIN EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-4661
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE SJH-2, PORTLAND, OR 97239
(503) 494-4910
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28220533A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
10004622
OR
Other
Enumeration date
01/12/2020
Last updated
02/14/2023
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