Healthcare Provider Details

I. General information

NPI: 1538250394
Provider Name (Legal Business Name): ANDREW L BOWER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2474 S.W. PERKINS AVE
PENDLETON OR
97801
US

IV. Provider business mailing address

2474 S.W. PERKINS AVE
PENDLETON OR
97801
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-1001
  • Fax: 541-966-1195
Mailing address:
  • Phone: 541-966-1001
  • Fax: 541-966-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD26075
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License NumberMD26075
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD26075
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: