Kandice Sue Bowman, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

200150120NP Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Phone

(503) 494-5604

Fax

(503) 494-4631

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1457404758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE: PV01",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-5604",
            "fax_number": "503-494-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-5604",
            "fax_number": "503-494-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "KANDICE",
        "middle_name": "SUE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "200150120NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrison Bowman, RPH
• James Scott Bowman, D.C.
• Jennifer L Bowman, MD
• Jennifer T Bowman
• Julianne Bowman, LMT
• Molly Bowman, MS, LPC
• Ronald Bowman, MD
• Sally Christine Bowman, LMT
• Summer Sky Bowman, LMT
• Tasha Bowman, BS CADC-R QMHA-R CRM

• Pediatric Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.