Individual
MOLLY K BUSHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10670 NE CORNELL RD STE 101, HILLSBORO, OR 97124-9221
(503) 216-9360
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
LD10162938
OR
363A00000X
Physician Assistant
Primary
PA187229
OR
Other
Enumeration date
06/24/2015
Last updated
02/15/2022
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