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NPI Code Detail

MEDICARE: NICHOLAS ANTHONY BONCHER MD

MEDICARE: NICHOLAS ANTHONY BONCHER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianMD166816OR
2208800000XUrology PhysicianMD2013-0220NM
3208800000XUrology PhysicianMD60864563WA

General Provider Information

NPI Number : 1255546982
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS ANTHONY BONCHER MD
Provider Business Mailing Address
First Line : 500 NE MULTNOMAH ST STE 100
Second Line :
City : PORTLAND
State : OR
Zip : 97232-2031
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12607 SE MILL PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98684-6055
Country : US
Telephone Number : 800-813-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 01/26/2026

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Directions to “ NICHOLAS ANTHONY BONCHER MD” Practice Location

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