IndividualActive
Elizabeth Boudreau, PA-C
NPI 1104544238 · Medical Physician Assistant · Portland, OR
Provider details
- NPI number
- 1104544238
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA217617 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3303 S Bond Ave
Portland, OR 97239-4501
Phone: (503) 494-5058
Fax: (503) 494-5065
Street-level locationGet directions
Mailing address
1400 Sw 5th Ave Ste 500
Portland, OR 97201-5537
Additional practice locations (1)
- 3181 Sw Sam Jackson Park RdPortland, OR 97239-3011Phone: (503) 494-6594Fax: (503) 494-4285
Registry dates
- Enumerated
- 2022-08-15
- Last updated
- 2024-01-10
- Certified
- 2024-01-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.