Healthcare Provider Details

I. General information

NPI: 1003538455
Provider Name (Legal Business Name): KOBZEFF ANESTHESIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16034 INVERURIE RD
LAKE OSWEGO OR
97035-4110
US

IV. Provider business mailing address

16034 INVERURIE RD
LAKE OSWEGO OR
97035-4110
US

V. Phone/Fax

Practice location:
  • Phone: 503-930-9443
  • Fax:
Mailing address:
  • Phone: 503-930-9443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ISAAC KOBZEFF
Title or Position: PRESIDENT
Credential: CRNA
Phone: 866-758-5972