Provider Demographics
NPI:1497930432
Name:SESSIONS, LANDON (CRNA)
Entity Type:Individual
Prefix:
First Name:LANDON
Middle Name:
Last Name:SESSIONS
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 1:6400 SE LAKE RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97222-2129
Mailing Address - Country:US
Mailing Address - Phone:503-594-1774
Mailing Address - Fax:503-594-1775
Practice Address - Street 1:6400 SE LAKE RD
Practice Address - Street 2:SUITE 109
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97222-2129
Practice Address - Country:US
Practice Address - Phone:503-594-1774
Practice Address - Fax:503-594-1775
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR63115367500000X
AZCRNA0647367500000X
OR201160021CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
55-0822024OtherTIN