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General NPI Number Information
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NPI Number | 1245542687
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Entity Type | Individual
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Provider Name | DIANNA JULIE SOELBERG CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 08/26/2016
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Provider Practice Location Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone | 503-494-7641
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Fax |
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Provider Business Mailing Address
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Address Line | 5736 SE LINCOLN ST
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City | PORTLAND
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State | OR
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Zip | 97215
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Country | US
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Telephone | 302-275-1544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN579938
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 201260039CRNA
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP60378755
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License Number State | WA
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