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Individual

AMBER L. BOWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
18040 SW LOWER BOONES FERRY RD, SUITE 100, TIGARD, OR 97224-7259
(503) 216-0700
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002013
CT
363A00000X
Physician Assistant
Primary
PA160669
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5006252806
OR
01
P01178826
RR MEDICARE - PH&S
OR
Enumeration date
12/03/2007
Last updated
02/15/2021
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