Individual
BRADLEY BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2526
(207) 662-6236
Mailing address
190 RIVERSIDE ST UNIT 6B, PORTLAND, ME 04103-1073
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA183057
ME
Other
Enumeration date
06/02/2016
Last updated
12/04/2018
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