Fernstrom, Bruce

Fernstrom, Bruce is an individual health care provider with primary practice located at 501 N Graham St Ste 420 , Portland OR 97227-2006. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Fernstrom, Bruce can be contacted via phone (503) 288-7303.

Contact Information

Primary practice address
501 N Graham St Ste 420 Portland OR 97227-2006
Phone: (503) 288-7303
Fax: (503) 288-3806
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00805 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA00805 Oregon

Profile Details

NPI number 1255329967
LBN Legal business name Fernstrom, Bruce
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2005
Last updated Jul 28th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255329967 NPPES
Oregon MEDICAID 500600862

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