Individual
CHARLES ROY BOARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4226 NE GRAND AVE, PORTLAND, OR 97211-3411
(503) 333-3977
Mailing address
4226 NE GRAND AVE, PORTLAND, OR 97211-3411
(503) 333-3977
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
562439
NY
163W00000X
Registered Nurse
—
OR
363LF0000X
Family Nurse Practitioner
Primary
—
OR
Other
Enumeration date
01/04/2007
Last updated
09/11/2025
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