person
Bruce Fernstrom, PA
Surgical Physician Assistant in Portland, Oregon
NPI 1255329967

Bruce Fernstrom is a Surgical Physician Assistant based in Portland, OR and is specialized in Surgical. Bruce Fernstrom practices in Portland, OR and has the professional credentials of PA. The NPI Number for Bruce Fernstrom is 1255329967 and holds a License No. PA00805 (Oregon).

The current practice location address for Bruce Fernstrom is 10000 Se Main St, Portland, OR and can be reached out via phone at 503-255-5524 and via fax at 503-255-5120.

Location: 10000 Se Main St, Portland, OR, 97232-2895
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Provider Profile Details
NPI Number
1255329967
Provider Name
Bruce Fernstrom
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
10000 Se Main St, Portland, OR, 97232-2895
Phone Number
503-255-5524
Fax Number
503-255-5120
Provider Enumeration Date
10/07/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500600862 05 OR
institution
Provider Business Practice Location Address Details
Address
10000 Se Main St
City
State
Zip
97216-2448
Phone Number
503-255-5524
Fax Number
503-255-5120
person
Provider Business Mailing Address Details
Address
10000 Se Main St
City
State
Zip
97216-2448
Phone Number
503-255-5524
Fax Number
503-255-5120
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA00805 (Oregon)
Definition
Definition to come...
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