Provider Demographics
NPI:1114441722
Name:BOWSER, WHITNEY (PA-C)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:BOWSER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6924 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-5256
Mailing Address - Country:US
Mailing Address - Phone:503-963-7963
Mailing Address - Fax:503-954-2122
Practice Address - Street 1:5657 S HIMALAYA ST STE 100
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5308
Practice Address - Country:US
Practice Address - Phone:303-699-6200
Practice Address - Fax:303-766-6903
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA198541363AM0700X
COPA.0005075363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1548261324OtherN/A