Individual
JACKALYN BOLGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
22067 SE HOWLETT RD, EAGLE CREEK, OR 97022-9764
(503) 637-3631
Mailing address
22067 SE HOWLETT RD, EAGLE CREEK, OR 97022-9764
(503) 637-3631
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2002242564RN
OR
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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