MEDICARE: OREGON OUTPATIENT ANESTHESIA ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1083499727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OREGON OUTPATIENT ANESTHESIA ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	4409 SW CARL PL
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-1518
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4409 SW CARL PL
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-1518
Country	:	US
Telephone Number	:	316-685-2371
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	JOHN MCCREARY
Credential	:
Telephone Number	:	971-404-6824

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	08/30/2023

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Directions to “OREGON OUTPATIENT ANESTHESIA ASSOCIATES LLC ” Practice Location

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