Individual
ROBERTA ANNE BULGER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11510 SE STARK ST, PORTLAND, OR 97216-3356
(503) 256-0636
(503) 408-7034
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD09855
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146936
—
OR
Enumeration date
04/19/2006
Last updated
07/08/2007
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