MEDICARE: SCOTT ALLEN CARVER 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	406	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922085760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT ALLEN CARVER CRNA

Provider Business Mailing Address
First Line	:	PO BOX 3706
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-3706
Country	:	US
Telephone Number	:	866-907-1068
Fax Number	:	425-917-9141

Provider Business Practice Location Address
First Line	:	1915 E REZANOF DR
Second Line	:
City	:	KODIAK
State	:	AK
Zip	:	99615-6602
Country	:	US
Telephone Number	:	907-486-3281
Fax Number	:	907-684-0421

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	09/30/2020

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Directions to “ SCOTT ALLEN CARVER CRNA” Practice Location

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