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Contact Information

ROGUE ANESTHESIA LLC
1601 NW HAWTHORNE AVE
GRANTS PASS, OR97526
 Phone: 541-472-4884
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for ROGUE ANESTHESIA LLC · (Female)

NPI # 1043248917
Status Active
Credentials
Entity Individual
Enumeration date 06/29/2006
Last updated 11/01/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR License # MD18872
  • OR Medicaid 130351
  • OR Other 023807000 REGENCE BCBSO
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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