Individual
PETER BODMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
255 LANCASTER DR NE, SALEM, OR 97301-5155
(503) 576-8400
(503) 364-0775
Mailing address
255 LANCASTER DR NE, SALEM, OR 97301-5155
(503) 576-8400
(503) 364-0775
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA174107
OR
Other
Enumeration date
09/16/2014
Last updated
03/03/2021
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