IndividualActive
Bruce Fernstrom, PA-C
NPI 1255329967 · Surgical Physician Assistant · Portland, OR
Provider details
- NPI number
- 1255329967
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA00805 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
501 N Graham St Ste 420
Portland, OR 97227-2006
Phone: (503) 288-7303
Fax: (503) 288-3806
Approximate (ZIP-level) locationGet directions
Mailing address
541 Ne 20th Ave Ste 225
Portland, OR 97232-2895
Additional practice locations (2)
- 1130 Nw 22nd Ave Ste 400Portland, OR 97210-2971Phone: (503) 413-6722
- 19250 Sw 65th Ave Ste 235Tualatin, OR 97062-7745Phone: (503) 692-4820Fax: (503) 612-0793
Registry dates
- Enumerated
- 2005-10-07
- Last updated
- 2025-07-28
- Certified
- 2025-07-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.