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General NPI Number Information
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NPI Number | 1457354557
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Entity Type | Individual
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Provider Name | BRUCE REID MANCHESTER C.R.N.A.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 09/18/2010
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Provider Practice Location Address
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Address Line | 3019 NW STEWART PKWY STE 304, PMB 108
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City | ROSEBURG
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State | OR
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Zip | 97471-1612
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Country | US
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Telephone | 503-313-4948
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Fax |
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Provider Business Mailing Address
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Address Line | 3019 NW STEWART PKWY STE 304, PMB 108
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City | ROSEBURG
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State | OR
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Zip | 97471-1612
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Country | US
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Telephone | 503-313-4948
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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 | 075034942CRNA
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License Number State | OR
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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 | 0024166633
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License Number State | VA
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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 | CRNA0530
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4681
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 356
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License Number State | AK
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Taxonomy #6
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP60119748
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License Number State | WA
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Taxonomy #7
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA00761
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License Number State | NM
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Taxonomy #8
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AA083180
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License Number State | ME
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Taxonomy #9
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CR000534
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License Number State | SD
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