Provider Demographics
NPI:1699888552
Name:BOWLES, JAMES ROBERT (CRNA,MA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:BOWLES
Suffix:
Gender:M
Credentials:CRNA,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22225 SE PEGGY ANN DR.
Mailing Address - Street 2:
Mailing Address - City:BORING
Mailing Address - State:OR
Mailing Address - Zip Code:97089
Mailing Address - Country:US
Mailing Address - Phone:503-658-4399
Mailing Address - Fax:
Practice Address - Street 1:22225 SE PEGGY ANN DR.
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:OR
Practice Address - Zip Code:97089
Practice Address - Country:US
Practice Address - Phone:503-658-4399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered