MEDICARE: MR. WILLIAM C. WHITACRE 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
1	367500000X	Certified Registered Nurse Anesthetist	28267047A	IN
2	367500000X	Certified Registered Nurse Anesthetist	201260035CRNA	OR

General Provider Information

NPI Number	:	1588635635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM C. WHITACRE CRNA

Provider Business Mailing Address
First Line	:	CMR 402 BOX 1852
Second Line	:
City	:	APO
State	:	AE
Zip	:	09180-0019
Country	:	US
Telephone Number	:	011491728253813
Fax Number	:

Provider Business Practice Location Address
First Line	:	6400 SE LAKE RD STE 130
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97222-2129
Country	:	US
Telephone Number	:	503-594-1774
Fax Number	:	503-594-1775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	11/20/2025

Similar Medicare Providers

1619973070 — DR. TERRY L ISOM DMD
Practice Location Address:

6400 SE LAKE RD , SUITE 140
PORTLAND, OR
97222-2129

Practice Phone: 503-496-4766
Practice Fax: 503-496-4700

1124112842 — MR. CRAIG G KLEIV CRNA
Practice Location Address:

6400 SE LAKE RD STE 300
PORTLAND, OR
97222-2129

Practice Phone: 503-594-1774
Practice Fax:

1518146802 — JANICE C. PREMO
Practice Location Address:

6400 SE LAKE RD STE 102
PORTLAND, OR
97222-2129

Practice Phone: 503-810-8111
Practice Fax:

1497930432 — LANDON SESSIONS CRNA
Practice Location Address:

6400 SE LAKE RD , SUITE 109
PORTLAND, OR
97222-2129

Practice Phone: 503-594-1774
Practice Fax: 503-594-1775

1427447143 — AT HOME PRIMARY CARE LLC.
Practice Location Address:

6400 SE LAKE RD # 420
PORTLAND, OR
97222-2129

Practice Phone: 503-344-6717
Practice Fax:

1992188445 — NATASHA LAUREN HARRISON
Practice Location Address:

6400 SE LAKE RD
PORTLAND, OR
97222-2129

Practice Phone: 541-213-1226
Practice Fax:

Directions to “ MR. WILLIAM C. WHITACRE CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.