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Individual

NANCY S BOUTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1015 3RD ST NW, SALEM, OR 97304-4007
(503) 588-3600
Mailing address
PO BOX 14001, SALEM, OR 97309-5014
(503) 561-5419

Taxonomy

Speciality
Code
Description
License number
State
2085H0002X
Hospice and Palliative Medicine (Radiology) Physician
Primary
MD13924
OR
2085R0001X
Radiation Oncology Physician
MD13924
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004650
OR
Enumeration date
07/27/2006
Last updated
02/17/2020
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