Organization
FOUR RIVERS ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E OHARA CRNA (OWNER)
(208) 642-9293
Entity
Organization
Contact information
Practice address
351 SW 9TH ST, ONTARIO, OR 97914
(541) 889-5331
Mailing address
5319 SW WESTGATE DR, #241, PORTLAND, OR 97221-2432
(503) 297-7223
(503) 297-7603
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
096007764CRNA
OR
Other
Enumeration date
05/30/2007
Last updated
11/01/2010
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