Individual
MR. BRANDON BOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP, FNP-BC
Contact information
Practice address
4212 SE DIVISION ST STE 100, PORTLAND, OR 97206-1680
(503) 963-2575
(503) 327-8796
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
(503) 764-9042
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP60801886
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10009817
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP60801886
WA
Other
Enumeration date
12/01/2014
Last updated
08/21/2024
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