Carissa Marie Bowman, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Clackamas, OR
NPI 1508569799 · NPPES record last updated Sep 25, 2023
Key facts
- NPI
- 1508569799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 10015490 (OR)
- Practice address
- 10180 SE Sunnyside Rd
Clackamas, OR 97015-8970 - Phone
- (503) 813-2000
- NPI assigned
- Mar 24, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kaiser Foundation Health Plan of the Northwest
Practice addresses (Care Compare)
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000
Hospital & facility affiliations
- Kaiser Sunnyside Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231113003050 | OR | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9234586215 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10015490 | OR | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 10015490 | OR | Yes |
Addresses
Primary practice location
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Mailing address
9208 NE 45TH PL
Vancouver, WA 98665-5360
Phone (360) 609-8878
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Other providers in Clackamas, OR
- Carol Born
- Eric Bosworth
- Krista Jewelene Bosworth
- Sherry Louise Bourdin
- Kyle Bowling
- Carla Jean Bowman
- Mary Palumbo Boyer
- Jason Aaron Brabec
- David Bradley
- Evelyn Brady
All providers in Clackamas, OR · Certified Registered Nurse Anesthetist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.