Healthcare Provider Details

I. General information

NPI: 1487795464
Provider Name (Legal Business Name): MANUEL DENNIS ARGUELLO CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9205 SW BARNES RD
PORTLAND OR
97225-6603
US

IV. Provider business mailing address

60 SW 144TH AVE
BEAVERTON OR
97006-5955
US

V. Phone/Fax

Practice location:
  • Phone: 503-216-7340
  • Fax:
Mailing address:
  • Phone: 503-352-9366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: