Healthcare Provider Details

I. General information

NPI: 1750650511
Provider Name (Legal Business Name): CASCADE ANESTHESIA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2011
Last Update Date: 12/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 COUNTRY CLUB RD
EUGENE OR
97401-6019
US

IV. Provider business mailing address

PO BOX 51389
EUGENE OR
97405-0907
US

V. Phone/Fax

Practice location:
  • Phone: 541-683-0878
  • Fax:
Mailing address:
  • Phone: 541-345-4343
  • Fax: 541-345-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JERALD A TURK
Title or Position: CEO
Credential: CRNA
Phone: 541-345-4343