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Individual

RALPH L LUELLEN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
500 SW RAMSEY AVE, GRANTS PASS, OR 97527-5554
(541) 474-7000
Mailing address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0609
(812) 801-0276

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
201402159CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
AP60203707
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300061265
IN
05
7100818350
KY
Enumeration date
01/20/2011
Last updated
10/09/2025
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