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General NPI Number Information
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NPI Number | 1306475181
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Entity Type | Organization
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Legal Business Name | BOBO PRIMARY CARE PC
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 304 SE HEARTHWOOD BLVD # 873933
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City | VANCOUVER
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State | WA
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Zip | 98684-7551
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Country | US
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Telephone | 702-849-3302
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Fax |
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Provider Business Mailing Address
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Address Line | 304 SE HEARTHWOOD BLVD # 8739933
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City | VANCOUVER
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State | WA
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Zip | 98684-7551
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Country | US
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Telephone | 503-877-5543
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Fax | 778-769-4717
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Authorized Official
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Title or Position | OWNER
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Name | BONA BOBO
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Credential | NP
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Telephone | 503-877-5543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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