Individual
STEVEN BOLGRIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
617 NW ALDER STREET, MCMINNVILLE, OR 97128
(503) 472-3989
Mailing address
PO BOX 1041, MCMINNVILLE, OR 97128
(503) 472-3989
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
980
OR
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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