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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ELLIE RAINES BOARDMAN

Active Sole Proprietor

ELLIE RAINES BOARDMAN is a Surgical Physician Assistant healthcare provider located in MILWAUKIE, Oregon. NPI 1346839347 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · MILWAUKIE, OR

Registration Details

NPI Number
1346839347
Provider Type
Individual
Gender
Female
NPI Issued
Jan 13, 2021 (5.6021011836379 yrs)
Last Updated
Jan 20, 2021
License
199221
Sole Proprietor
Yes

Practice Information

Address
15074 SE BEVINGTON AVE
MILWAUKIE, OR, 97267
Browse OR providers · Browse ZIP 97267
Phone
5033070159
Primary Specialty
Surgical Physician Assistant
363AS0400X
Additional Specialty
Surgical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.