MIRANDA RESHAE BOSTIC

PORTLAND, OR
NPI1346668050
Former NameMIRANDA RESHAE WARD
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: OR  10042383)
Additional Taxonomies363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TN  26208)
363L00000X Nurse Practitioner
(Licence: TN  26208)
Enumeration Date2014-03-31
Last Update Date2025-09-18
Business Address
MIRANDA RESHAE BOSTIC PMHNP-BC
5441 S MACADAM AVE STE A
PORTLAND, OR 97239-3822
Phone number: 541-248-1204
Mailing Address
MIRANDA RESHAE BOSTIC PMHNP-BC
5441 S MACADAM AVE STE A
PORTLAND, OR 97239-3822
Phone number: 541-248-1204