Individual
MR. DENNIS G GUNDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
342 FAIRVIEW ST, SILVERTON, OR 97381
(503) 873-1500
Mailing address
5319 SW WESTGATE DR, #241, PORTLAND, OR 97221-2432
(503) 297-7233
(503) 297-7603
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
082011439
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075952
—
OR
01
—
807251005
REGENCE BCBSO
OR
Enumeration date
06/09/2006
Last updated
07/14/2010
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