Individual
EMILY J BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-8652
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8652
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD211364
OR
390200000X
Student in an Organized Health Care Education/Training Program
PG188403
OR
390200000X
Student in an Organized Health Care Education/Training Program
PG193428
OR
Other
Enumeration date
05/17/2018
Last updated
10/31/2022
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