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 multi-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 Pia Shivdasani . The authorized official title is Vp Operations, Authorized Agent and has the following contact phone number (888) 288-4715.
The enumeration date for this NPI number is 6/4/2019 and was last updated on 6/26/2024.
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:
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.
This page was last updated on: 11/21/2025
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