Individual provider · Type 1 NPI
Charles Roy Boardman, RN
Family Nurse Practitioner · Portland, OR
NPI number
1720135643
Active
Practice location
4226 NE Grand Ave
Portland, OR 97211-3411
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 562439 (NY) |
| Registered Nurse | 163W00000X | None listed |
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
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About NPI 1720135643
Charles Roy Boardman, RN's National Provider Identifier is 1720135643, issued on Jan 4, 2007. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Portland, OR. The record was last updated on Sep 11, 2025.