Individual
WAYNE NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10180 SE SUNNYSIDE ROAD, CLACKAMAS, OR 97015-9764
(503) 652-2880
Mailing address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-4506
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
OR
Other
Enumeration date
08/30/2006
Last updated
07/20/2007
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