Boardman Surgical LLC

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Legal business name

BOARDMAN SURGICAL LLC

Practice address

1500 Division St
Oregon City, OR 97045-1527

Phone

(503) 650-6762

NPI assigned

Jan 14, 2021

Organization subpart

No

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

Authorized official

Name

Ellie Boardman, CSFANPI 1346839347

Title

Owner

Phone

(503) 307-0159

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ellie Raines Boardman

  • Surgical Physician Assistant
  • Milwaukie, OR
  • NPI 1346839347

  Surgical Assistant

  NPD Authorized official

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1972192896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15074 SE BEVINGTON AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972673357",
            "telephone_number": "503-307-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DIVISION ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451527",
            "telephone_number": "503-650-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARDMAN SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "BOARDMAN",
        "authorized_official_first_name": "ELLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-307-0159",
        "authorized_official_credential": "CSFA"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Blixhavn
• Michelle Renee Bloemers, DMD
• Nikki Blomquist
• Blossoming Spring Acupuncture
• Carter Blue, L.AC.
• Charles Joseph Bock Jr., MD
• Holly Ann Boehm, CNM
• Marilynn Jane Bohnstedt-Casey, FNP
• Ashley N Bohr
• Jordain Elaine Boland, MS, QMHP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.