Boston, Bruce Alan

Boston, Bruce Alan is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Endocrinology, which is considered as his primary health care specialty. Boston, Bruce Alan can be contacted via phone (503) 494-1926.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X MD16035 Oregon

Profile Details

NPI number 1003821505
LBN Legal business name Boston, Bruce Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Aug 13th, 2007 - about 17 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 1003821505 NPPES
Oregon MEDICAID 072582

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