Provider Demographics
NPI:1558579300
Name:TREMAINE, DONNA ANNE (MSN)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:ANNE
Last Name:TREMAINE
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:ANNE
Other - Last Name:BERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 KERR PKWY APT 22
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8831
Mailing Address - Country:US
Mailing Address - Phone:503-347-5695
Mailing Address - Fax:
Practice Address - Street 1:10180 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8970
Practice Address - Country:US
Practice Address - Phone:503-652-2990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL000532CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered