Provider Demographics
NPI:1285795625
Name:CLACKAMAS SURGICAL ASSOCIATES, INC.
Entity type:Organization
Organization Name:CLACKAMAS SURGICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:CRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-655-6313
Mailing Address - Street 1:1510 DIVISION ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1581
Mailing Address - Country:US
Mailing Address - Phone:503-655-6313
Mailing Address - Fax:503-655-6781
Practice Address - Street 1:1510 DIVISION ST
Practice Address - Street 2:SUITE 210
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1581
Practice Address - Country:US
Practice Address - Phone:503-655-6313
Practice Address - Fax:503-655-6781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty