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BOARDMAN SURGICAL LLC
NPI 1033700059
Physician Assistant - Surgical in Milwaukie, OR

Active since February 02, 2021
15074 SE BEVINGTON AVE, MILWAUKIE, OR 97267(503) 307-0159 Get Directions Write a Review

NPPES record last updated: February 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Boardman Surgical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOARDMAN SURGICAL LLC (NPI 1033700059) is a healthcare organization registered as a surgical in Milwaukie, Oregon and active in the NPI registry since February 2021. The organization lists Ellie Boardman, Owner, as its authorized official.

NPPES Registry Identity

NPI1033700059
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NameBOARDMAN SURGICAL LLC
Location Address15074 SE BEVINGTON AVEMilwaukie, OR 97267-3357
Mailing Address15074 Se Bevington AveMilwaukie, OR 97267-3357 · (503) 307-0159
Phone(503) 307-0159
Organization SubpartNo
Authorized OfficialEllie BoardmanOwner · (503) 307-0159
Enumeration DateFebruary 2, 2021
Last NPPES UpdateFebruary 3, 2021
NPPES CertifiedFebruary 3, 2021
✔ NPI 1033700059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
Also ListedSpecialist/Technologist, Other · Surgical AssistantTaxonomy 246ZC0007X
15074 SE BEVINGTON AVE, Milwaukie, OR 97267
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Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELLIE RAINES BOARDMAN
Physician Assistant (Surgical)
15074 SE BEVINGTON AVE
MILWAUKIE, OR 97267
Clackamas County (503) 307-0159

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boardman Surgical LLC's NPI number?

The NPI number for Boardman Surgical LLC is 1033700059. It was assigned to this organization in the NPPES registry on February 2, 2021.

Where is Boardman Surgical LLC located?

Boardman Surgical LLC is located at 15074 SE Bevington Ave, Milwaukie, OR 97267. The listed phone number is (503) 307-0159.

What is Boardman Surgical LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Boardman Surgical LLC was last updated on February 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.