Individual
BRUCE ALAN BOSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-1926
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
MD16035
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072582
—
OR
Enumeration date
07/31/2006
Last updated
08/13/2007
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