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1255329967
BRUCE FERNSTROM
PORTLAND, OR
NPI
1255329967
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: OR PA00805)
Enumeration Date
2005-10-07
Last Update Date
2023-12-05
Business Address
BRUCE FERNSTROM PA
10000 SE MAIN ST SUITE 342
PORTLAND, OR 97216-2448
Phone number: 503-255-5524
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Mailing Address
BRUCE FERNSTROM PA
541 NE 20TH AVE STE 225
PORTLAND, OR 97232-2895
Phone number: 503-963-2801
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