Provider Demographics
NPI:1124046792
Name:RAMSEY, FRED JOSEPH (CRNA)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:JOSEPH
Last Name:RAMSEY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 BLANKENSHIP RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4181
Mailing Address - Country:US
Mailing Address - Phone:503-655-3851
Mailing Address - Fax:503-655-3318
Practice Address - Street 1:1830 BLANKENSHIP RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4181
Practice Address - Country:US
Practice Address - Phone:503-655-3851
Practice Address - Fax:503-655-3318
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR084056706RN163W00000X
OR084056706CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR067145Medicaid
OR067145Medicaid