Provider Demographics
NPI:1568459899
Name:ATTALLA, LORRAINE F (CRNA)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:F
Last Name:ATTALLA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 OAK ST
Mailing Address - Street 2:OREGON EYE SURGERY CENTER
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7701
Mailing Address - Country:US
Mailing Address - Phone:541-484-4988
Mailing Address - Fax:541-434-0960
Practice Address - Street 1:1550 OAK ST
Practice Address - Street 2:OREGON EYE SURGERY CENTER
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7701
Practice Address - Country:US
Practice Address - Phone:541-683-8771
Practice Address - Fax:541-484-4993
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR022964Medicaid
OR022964Medicaid
R80612Medicare UPIN