Active NPI
Bruce A Free, DO
- Family Medicine Physician
- Portland, OR
National Provider Identifier
1619931979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO11383
- Practice address
- 10201 SE Main St
Suite 29
Portland, OR 97216-2937 - Phone
- (503) 251-6363
- Fax
- (503) 251-6239
- NPI assigned
- Apr 13, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO11383 | OR | Primary |
Addresses
Primary practice location
10201 SE Main St
Suite 29
Portland, OR 97216-2937
Mailing address
10201 SE Main St
Suite 29
Portland, OR 97216-2937
Phone (503) 251-6363
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0186932 | Other | WA | WA LABOR & INDUSTRIES |
| 123356 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11383 | OR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| DO11383 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1619931979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10201 SE MAIN ST",
"address_2": "SUITE 29",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972162937",
"telephone_number": "503-251-6363",
"fax_number": "503-251-6239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10201 SE MAIN ST",
"address_2": "SUITE 29",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972162937",
"telephone_number": "503-251-6363",
"fax_number": "503-251-6239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREE",
"first_name": "BRUCE",
"middle_name": "A",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "DO11383",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA LABOR & INDUSTRIES",
"identifier": "0186932",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123356",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.