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NPI Code Detail

MEDICARE: JOHN DEAN BOYLE PA

MEDICARE: JOHN DEAN BOYLE PA
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
1363AM0700XMedical Physician AssistantPA01222OR

General Provider Information

NPI Number : 1528100864
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN DEAN BOYLE PA
Provider Business Mailing Address
First Line : 1508 DIVISION ST STE 105
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-1584
Country : US
Telephone Number : 503-656-0836
Fax Number : 503-656-9464
Provider Business Practice Location Address
First Line : 7401 SW WASHO CT STE 100
Second Line :
City : TUALATIN
State : OR
Zip : 97062-8342
Country : US
Telephone Number : 503-656-0836
Fax Number : 503-656-9464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 03/05/2026

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