Bodmer, Andrew David

Bodmer, Andrew David is an individual health care provider with primary practice located at 18040 Sw Lower Boones Ferry Rd Suite 100, Tigard OR 97224-7259. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Bodmer, Andrew David can be contacted via phone (503) 216-0700.

Contact Information

Primary practice address
18040 Sw Lower Boones Ferry Rd Suite 100 Tigard OR 97224-7259
Phone: (503) 216-0700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X T-4239 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA161375 Oregon

Profile Details

NPI number 1083860548
LBN Legal business name Bodmer, Andrew David
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2008
Last updated Oct 5th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083860548 NPPES
Oregon MEDICAID 500655799

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