# GEOFFREY BUNCKE MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225215015
- **Authorized official:** MISS CHARISSE PETERSON (BILLING)
- **Authorized official phone:** (503) 973-5000

## Contact information

- **Practice address:** 1040 NW 22ND, SUITE 550, PORTLAND, OR 97210
- **Practice address phone:** (503) 973-5000
- **Practice address fax:** (503) 274-0188
- **Mailing address:** 1040 NW 22ND, SUITE 550, PORTLAND, OR 97210
- **Mailing address phone:** (503) 973-5000
- **Mailing address fax:** (503) 274-0188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2082S0105X | Surgery of the Hand (Plastic Surgery) Physician | MD23806 | OR | Yes |

## Other

- **Enumeration date:** 01/24/2008
- **Last updated:** 04/24/2012