Provider Demographics
NPI:1235202995
Name:FORTIER, JOSEPH LEONCE (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LEONCE
Last Name:FORTIER
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 1:5285 YORK HILL DR
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9611
Mailing Address - Country:US
Mailing Address - Phone:541-386-1644
Mailing Address - Fax:
Practice Address - Street 1:811 13TH ST
Practice Address - Street 2:PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031
Practice Address - Country:US
Practice Address - Phone:541-386-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered