Provider Demographics
NPI:1356643589
Name:HUNSAKER, ERICH (CRNA)
Entity type:Individual
Prefix:
First Name:ERICH
Middle Name:
Last Name:HUNSAKER
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 1:17133 SW PLOVER CT
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8970
Mailing Address - Country:US
Mailing Address - Phone:503-625-5116
Mailing Address - Fax:
Practice Address - Street 1:17133 SW PLOVER CT
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-8970
Practice Address - Country:US
Practice Address - Phone:503-625-5116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201040687RN163W00000X
OR201360012CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse