Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD20970 | OR |
N | 208600000X | Surgeon | MD20970 | OR |
N | 2086S0129X | Vascular Surgeon | MD20970 | OR |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD20970 | OR |
NPI | 1114987682 |
---|---|
Provider Name | Jeffrey F Boskind |
First Address | Portland, OR 97216-2448 |
Second Address | Portland, OR 97216-2448 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 18/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
151102 | (05) | OR |
G05491 | (02) |