Provider Demographics
NPI:1255867065
Name:BOSSMANN, JAMES PATRICK (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:BOSSMANN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:BOSSMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1700 NW CIVIC DR STE 310
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3774
Mailing Address - Country:US
Mailing Address - Phone:503-666-8832
Mailing Address - Fax:
Practice Address - Street 1:1700 NW CIVIC DR STE 310
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3774
Practice Address - Country:US
Practice Address - Phone:503-666-8832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD610387942084P0800X
ORMD2051782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry