Provider Demographics
NPI:1518994243
Name:SILVERTON ANESTHESIA GROUP LLC
Entity Type:Organization
Organization Name:SILVERTON ANESTHESIA GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERLING
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:503-873-1500
Mailing Address - Street 1:1000 WILLAGILLESPIE RD
Mailing Address - Street 2:350
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2178
Mailing Address - Country:US
Mailing Address - Phone:541-343-0952
Mailing Address - Fax:503-343-8034
Practice Address - Street 1:342 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381
Practice Address - Country:US
Practice Address - Phone:503-873-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR807251000OtherREGENCE BCBSO
OR287240Medicaid
ORR109974Medicare PIN