Individual
DR. PAUL G BOURESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3377 RIVERBEND DR, SPRINGFIELD, OR 97477-8800
(541) 222-6400
Mailing address
PO BOX 24410, EUGENE, OR 97402-0451
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD20093
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082417
—
OR
01
—
P370012349
RAILROAD MEDICARE
OR
Enumeration date
02/06/2006
Last updated
12/01/2008
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