Ileana Bourland, MSOM LICAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC153140 Issued in OR

Practice address

334 NE Irving Ave
Ste 102
Bend, OR 97701-4710

Phone

(512) 736-6122

Fax

(541) 617-0377

NPI assigned

Sep 8, 2006

Sex

Female

Sole proprietor

Yes

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1861596074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 NE IRVING AVE",
            "address_2": "STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014710",
            "telephone_number": "512-736-6122",
            "fax_number": "541-617-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 NE IRVING AVE",
            "address_2": "STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014710",
            "telephone_number": "512-736-6122",
            "fax_number": "541-617-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURLAND",
        "first_name": "ILEANA",
        "name_prefix": "Miss",
        "credential": "MSOM LICAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC153140",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC00534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria C Boudinot, M.S.
• Shelby Kathryn Boudreau
• Molly Laura Bourgault, NP
• Kevin J. Bourlai, PT
• Bobbi Alison Bourland
• Daniel Joseph Bourque, D.C.
• Elizabeth Philbin Bouvier, MA
• Catherine Bowen
• Gregory Bowers
• Geneva R Bowman

• Acupuncturist in Bend, OR
• Providers in Bend, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.