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General NPI Number Information
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NPI Number | 1265497655
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Entity Type | Individual
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Provider Name | MICHAEL E OHARA CRNA
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 351 SW 9TH ST
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City | ONTARIO
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State | OR
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Zip | 97914
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Country | US
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Telephone | 541-881-7140
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Fax |
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Provider Business Mailing Address
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Address Line | 5319 SW WESTGATE DR #241
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City | PORTLAND
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State | OR
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Zip | 97221-2432
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Country | US
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Telephone | 503-297-7223
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Fax | 503-297-7603
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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 | 096007764
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License Number State | OR
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