Individual
KIRSTEN BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA205597
OR
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500795490
—
OR
Enumeration date
07/26/2019
Last updated
01/04/2022
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