Individual
BRIDGET THERESA O'BOYLE-JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
21900 WILLAMETTE DR STE 202, WEST LINN, OR 97068-3284
(503) 653-0631
(503) 653-1464
Mailing address
PO BOX 574, MAIL CODE CDRC, PORTLAND, OR 97207-0574
(503) 494-0429
(503) 494-4447
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
200541965RN
OR
363LP0200X
Pediatric Nurse Practitioner
Primary
200550154NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023299
—
OR
Enumeration date
08/01/2006
Last updated
07/27/2021
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