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NPI Code Detail

MEDICARE: DOUGLAS G BUFKIN CRNA

MEDICARE: DOUGLAS G BUFKIN CRNA
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
1367500000XCertified Registered Nurse Anesthetist201260043CRNAOR
2367500000XCertified Registered Nurse Anesthetist299836AZ

General Provider Information

NPI Number : 1104132356
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS G BUFKIN CRNA
Provider Business Mailing Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number : 503-494-7641
Fax Number : 503-494-8368
Provider Business Practice Location Address
First Line : 4605 E ELWOOD ST STE 500
Second Line :
City : PHOENIX
State : AZ
Zip : 85040-1978
Country : US
Telephone Number : 602-200-9021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2010
Last Update Date : 02/08/2024

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Directions to “ DOUGLAS G BUFKIN CRNA” Practice Location

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