Organization
CHETCO ANESTHESIA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RUSH DO (CEO)
(503) 650-4359
Entity
Organization
Contact information
Practice address
648 CHETCO AVE, BROOKINGS, OR 97415
(503) 650-4359
(503) 650-6913
Mailing address
PO BOX 8021, BROOKINGS, OR 97415-0376
(503) 650-4359
(503) 650-6913
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
—
OR
Other
Enumeration date
03/02/2007
Last updated
07/23/2007
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