Individual
VICKI K BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4400 NE HALSEY ST BLDG 23, PORTLAND, OR 97213-1545
(888) 227-3312
Mailing address
PO BOX 3229, PORTLAND, OR 97208-3229
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
202102582NP-PP
OR
363LC1500X
Community Health Nurse Practitioner
AP30005828
WA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
AP30005828
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9630351
—
WA
Enumeration date
07/05/2006
Last updated
03/02/2022
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