Individual
CRAIG ANDREW BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
61615 ATHLETIC CLUB DRIVE, BEND, OR 97702-3124
(541) 382-7890
(541) 382-7498
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4247
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228887
—
OR
01
—
P1567045
RR MEDICARE
OR
Enumeration date
12/07/2005
Last updated
01/28/2016
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