BOULDER CARE PROVIDER GROUP PA NPI 1649838590

NPI Information

BOULDER CARE PROVIDER GROUP PA is an addiction medicine family medicine in Portland, OR. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. BOULDER CARE PROVIDER GROUP PA NPI is 1649838590. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Boulder Care.

The provider's business location address is:

111 SW NAITO PKWY STE 200
PORTLAND, OR
ZIP 97204-512
Phone: (888) 316-0451

The provider's authorized official is Alyson L Smith .
The authorized official title is Medical Director and has the following contact phone number (760) 684-8535.

The enumeration date for this NPI number is 6/4/2019 and was last updated on 9/15/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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