Organization
ANESTHESIA ASSOCIATES NORTHWEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN DEREMER MD (MANAGER)
(954) 545-0337
Entity
Organization
Contact information
Practice address
10150 SE 32ND AVE, MILWAUKIE, OR 97222-6516
(503) 513-8300
Mailing address
PO BOX 2817, PORTLAND, OR 97208-2817
(954) 545-0337
(954) 545-3497
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
UNK
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213409
—
OR
01
—
611612700
WORKMANS COMP
OR
01
—
865351000
BLUE CROSS
OR
01
—
DD8686
RAILROAD MEDICARE
OR
Enumeration date
07/22/2006
Last updated
12/29/2021
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