Individual
TINA M BENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-8368
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE SJH-2, PORTLAND, OR 97239-3011
(503) 494-4910
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201508460RN
OR
163W00000X
Registered Nurse
RN. 0103612
CO
367500000X
Certified Registered Nurse Anesthetist
0004560CRNA
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
201508486CRNA
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004560
CRNA CO
CO
05
—
03178820
—
CO
01
—
1558379156
NPI
—
01
—
201508486
CRNA
OR
01
—
C801056
MEDICARE ID
CO
Enumeration date
08/03/2006
Last updated
12/01/2017
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