Healthcare Provider Details

I. General information

NPI: 1831102722
Provider Name (Legal Business Name): OUTPATIENT ANESTHESIA SOLUTIONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 CHAIN BRIDGE RD
MCLEAN VA
22101
US

IV. Provider business mailing address

PO BOX 9283
MCLEAN VA
22102-2522
US

V. Phone/Fax

Practice location:
  • Phone: 703-790-5454
  • Fax:
Mailing address:
  • Phone: 703-442-8599
  • Fax: 703-442-7707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024045604
License Number StateVA

VIII. Authorized Official

Name: MRS. DEBORAH JEANNE RICHARDSON
Title or Position: PRESIDENT OUTPATIENT ANESTHESIA SOL
Credential: CRNA
Phone: 703-442-8599