Individual
BRUCE FERNSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
501 N GRAHAM ST STE 420, PORTLAND, OR 97227-2006
(503) 288-7303
(503) 288-3806
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA00805
OR
363AS0400X
Surgical Physician Assistant
Primary
PA00805
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500600862
—
OR
Enumeration date
10/07/2005
Last updated
07/28/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us