Provider Demographics
NPI:1902061534
Name:CASCADE ANESTHESIA SERVICES PC
Entity Type:Organization
Organization Name:CASCADE ANESTHESIA SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JERALD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:TURK
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:541-484-0271
Mailing Address - Street 1:PO BOX 51389
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-0907
Mailing Address - Country:US
Mailing Address - Phone:541-345-4343
Mailing Address - Fax:541-345-4350
Practice Address - Street 1:85463 SVARVERUD RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-9427
Practice Address - Country:US
Practice Address - Phone:541-345-4343
Practice Address - Fax:541-345-4350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR134507Medicare PIN