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Individual

MR. BRIAN JAMES BOERMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A

Contact information

Practice address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Mailing address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401010452
MI
101YP2500X
Professional Counselor
Primary
C5728
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500794921
OR
01
B176375
ODL
OR
Enumeration date
06/26/2007
Last updated
07/29/2022
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