Provider Demographics
NPI:1477115947
Name:SALMOND, BOBBI JEAN (RN)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:JEAN
Last Name:SALMOND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BOBBI
Other - Middle Name:JEAN
Other - Last Name:CASSELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10220 SW GREENBURG RD STE 400
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5531
Mailing Address - Country:US
Mailing Address - Phone:503-452-7979
Mailing Address - Fax:866-941-4307
Practice Address - Street 1:10220 SW GREENBURG RD STE 400
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5531
Practice Address - Country:US
Practice Address - Phone:503-452-7979
Practice Address - Fax:866-941-4307
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201810396RN163W00000X
WARN00142231163W00000X
372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR163WP0808XMedicaid
WA163WP0808XMedicaid