Individual
MR. MATTHEW ALEXANDER BUNKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-8368
Mailing address
3181 SW SAM JACKSON PARK RD, OHSU ANESTHESIOLOGY, PORTLAND, OR 97239-3306
(503) 494-7641
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA182715
OR
363AM0700X
Medical Physician Assistant
C5-0000582
DE
363AM0700X
Medical Physician Assistant
Primary
PA182715
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA182715
PHYSICIAN ASSISTANT LICENSE
OR
Enumeration date
01/21/2009
Last updated
01/15/2021
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