Kevin Christopher Bolen, CST/CSFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

187722 Issued in CO

Practice address

1046 6TH Ave SW
Albany, OR 97321-1916

Phone

(541) 812-4000

NPI assigned

Apr 26, 2019

Last updated

Apr 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1376107250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 SE CRANBERRY LOOP",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158525",
            "telephone_number": "971-237-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 6TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211916",
            "telephone_number": "541-812-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLEN",
        "first_name": "KEVIN",
        "middle_name": "CHRISTOPHER",
        "credential": "CST/CSFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-26",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "CO",
            "license": "187722",
            "primary": true
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "CO",
            "license": "187722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Boggess, PH.D.
• Cristina Boguna Falco, QMHP
• Julie Bohlman
• Bruce Bohman, MD
• Melinda Boland
• Jamie Bolish
• Jessica Bollman
• Micah Bombardier, QMHA
• Chelsea Bond, PHARM.D.
• Lauren Michelle Book

• Surgical Assistant in Albany, OR
• Providers in Albany, OR by specialty
• Surgical Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.