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NPI Code Detail

MEDICARE: MICHELE K BOUCHE CNM

MEDICARE: MICHELE K BOUCHE CNM
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
1367A00000XAdvanced Practice Midwife084055791N5OR
2176B00000XMidwife084055791N5OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992762405
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE K BOUCHE CNM
Provider Business Mailing Address
First Line : PO BOX 3390
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3390
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 917 11TH ST
Second Line : SUITE 200
City : HOOD RIVER
State : OR
Zip : 97031-1578
Country : US
Telephone Number : 541-387-8940
Fax Number : 541-387-8908
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 08/31/2012

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Directions to “ MICHELE K BOUCHE CNM” Practice Location

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