Healthcare Provider Details

I. General information

NPI: 1942218094
Provider Name (Legal Business Name): MARK A FINKBEINER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 EXCHANGE ST
ASTORIA OR
97103-3329
US

IV. Provider business mailing address

1103 SW RIDGE RD
WARRENTON OR
97146-9440
US

V. Phone/Fax

Practice location:
  • Phone: 503-623-4321
  • Fax:
Mailing address:
  • Phone: 503-861-9663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number096006417
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: