Bulisco, Ethan
Bulisco, Ethan is an individual health care provider with primary practice located at 5331 S Macadam Ave Ste 287 , Portland OR 97239-3849. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Bulisco, Ethan can be contacted via phone (503) 635-3416.Contact Information
Primary practice address
5331 S Macadam Ave Ste 287
Portland OR 97239-3849
Phone: (503) 635-3416
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X |
Profile Details
| NPI number | 1073355798 |
|---|---|
| LBN Legal business name | Bulisco, Ethan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2024 |
| Last updated | Jun 12th, 2024 - about last year |
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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