BOULDER CARE PROVIDER GROUP PA

PORTLAND, OR
NPI1649838590
Doing Business AsBOULDER CARE
Entity TypeOrganization
Authorized ContactPIA SHIVDASANI
VP Operations, Authorized Agent
888-288-4715
Organization Subpart ?No
Primary Taxonomy207QA0401X Family Medicine, Addiction Medicine
Enumeration Date2019-06-04
Last Update Date2024-06-26
Business Address
BOULDER CARE PROVIDER GROUP PA
111 SW NAITO PKWY STE 200
PORTLAND, OR 97204-3512
Phone number: 888-316-0451
Mailing Address
BOULDER CARE PROVIDER GROUP PA
111 SW NAITO PKWY STE 200
PORTLAND, OR 97204-3512
Phone number: 503-208-5061