Individual
MS. CHRISTINE MARIE BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9155 SW BARNES RD, SUITE 317, PORTLAND, OR 97225-6625
(503) 216-1150
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
83038759
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150653
—
OR
Enumeration date
02/23/2007
Last updated
01/13/2016
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