ELLIE RAINES BOARDMAN

MILWAUKIE, OR
NPI1346839347
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363AS0400X Physician Assistant Surgical
Additional Taxonomies246ZC0007X Specialist/Technologist, Other Surgical Assistant
(Licence:   199221)
Enumeration Date2021-01-13
Last Update Date2021-01-20
Business Address
ELLIE RAINES BOARDMAN
15074 SE BEVINGTON AVE
MILWAUKIE, OR 97267
Phone number: 503-307-0159
Mailing Address
ELLIE RAINES BOARDMAN
15074 SE BEVINGTON AVE
MILWAUKIE, OR 97267
Phone number: 503-307-0159