| NPI | 1528000874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD ADRIAN WALLACE President 503-372-2740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-08-22 |