Laura M Bolt (NPI# 1124438205, PAC ID# 3577871169) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1124438205 |
| PAC ID by PECOS | 3577871169 |
| Professional Enrollment ID | I20150930003417 |
| Full Name | Laura M Bolt |
| Organization Legal Name | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER |
| Address |
1130 Ne 22nd Ave Portland OR 97210-2902 |
| Phone Number | 5034134048 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0547179939 |
| Number of Group Practice Members | 117 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380017 | LEGACY GOOD SAMARITAN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1015 Nw 22nd Ave, Portland, OR 97210-3025 | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER | |
| 1130 Ne 22nd Ave, Portland, OR 97210-2902 | 5034134048 | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER |
| Organization Legal Name | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER |
| Physicians | 95 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura M Wallace | Physician Assistant | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Thomas F Schrattenholzer | Pain Management | Legacy Good Samaritan Hospital and Medical Center | 1200 Nw 23rd Ave, Portland, OR 97210-2906 |
| Brian W Battalia | Emergency Medicine | Legacy Good Samaritan Hospital and Medical Center | 1015 Nw 22nd Ave, Portland, OR 97210-3025 |
| Brandy Masters Carpenter | Nurse Practitioner | Legacy Good Samaritan Hospital and Medical Center | 1130 Nw 22nd Ave, Suite 120, Portland, OR 97210-2934 |
| Tasha N Searles | Certified Clinical Nurse Specialist (cns) | Legacy Good Samaritan Hospital and Medical Center | 1040 Nw 22nd Ave, Suite 520, Portland, OR 97210-3097 |
| Piper H Sullivan | Physician Assistant | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Stephanie L Brell | Clinical Social Worker | Legacy Good Samaritan Hospital and Medical Center | 1200 Nw 23rd Ave, Portland, OR 97210-2906 |
| Geraldine L Stratton | Emergency Medicine | Legacy Good Samaritan Hospital and Medical Center | 1015 Nw 22nd Ave, Portland, OR 97210-3025 |
| Kathryn A Price | Pain Management | Legacy Good Samaritan Hospital and Medical Center | 1200 Nw 23rd Ave, Portland, OR 97210-2906 |
| Stefanie Avery | Nurse Practitioner | Legacy Good Samaritan Hospital and Medical Center | 1015 Nw 22nd Ave, Portland, OR 97210-3025 |
| Street Address |
1130 NE 22ND AVE |
| City | PORTLAND |
| State | OR |
| Zip | 97210-2902 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura M Wallace | Physician Assistant | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Piper H Sullivan | Physician Assistant | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Brandy Pestka | Physician Assistant | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Elizabeth Ann Alston | Nurse Practitioner | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Susan M Doucette | Qualified Audiologist | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Elaine Marie B Adair | Physician Assistant | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Valerie Rae Correa | Psychologist, Clinical | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Debra Lauren Diaz | Physician Assistant | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Viken Douzdjian | General Surgery | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| William M Bennett | Nephrology | Legacy Good Samaritan Hospital and Medical Center | 1130 Ne 22nd Ave, Portland, OR 97210-2902 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul G Brown | Clinical Psychologist | 2134 Nw Aspen Ave, Portland, OR 97210-1217 | |
| Megan A Banker | Chiropractic | 2232 Nw Pettygrove St, Suite 110, Portland, OR 97210-2372 | |
| Gail F Ott | Chiropractic | Megan Banker Dc PC | 2232 Nw Pettygrove St, Suite 110, Portland, OR 97210-2372 |
| Carol Stimpson Christensen | Clinical Social Worker | 2520 Nw Upshur St, Portland, OR 97210-2550 | |
| Laurence W Christensen | Clinical Psychologist | 2520 Nw Upshur St, Portland, OR 97210-2550 | |
| Karen B Kelsall | Chiropractic | 1615 Nw23rd Ave, Suite 2, Portland, OR 97210-2563 | |
| Anthony U Weber | Chiropractic | Kelsall Chiropractic Clinic PC | 1615 Nw23rd Ave, Portland, OR 97210-2563 |
| Tony Farrenkopf | Psychologist, Clinical | 2256 Nw Pettygrove St, Portland, OR 97210-2608 | |
| Kimberly Michiko Nakayama | Qualified Audiologist | Northwest Ear Institute PC | 2230 Nw Pettygrove St, Suite 120, Portland, OR 97210-2659 |
| Jeffrey Christopher La Rochelle | Urology | Northwest Urology LLC | 2230 Nw Pettygrove, Suite 210, Portland, OR 97210-2659 |
| Find all physicians in zip 97210 | |||
| City | PORTLAND |
| Zip Code | 97210 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | PORTLAND + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Laura M Bolt.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.