Healthcare Provider Details

I. General information

NPI: 1154876183
Provider Name (Legal Business Name): CAMERON MCGUIRE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 SW ABBEY ST
NEWPORT OR
97365-4820
US

IV. Provider business mailing address

PO BOX 2847
CORVALLIS OR
97339-2847
US

V. Phone/Fax

Practice location:
  • Phone: 541-265-2244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number201811365CRNA-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: