DURRELL J BOLDS
NPI 1366960890
Counselor - Mental Health in Portland, OR

The NPI number for Durrell Bolds is 1366960890. It was assigned to this individual provider in the NPPES registry on September 5, 2017.

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

The NPPES record for Durrell Bolds was last updated on September 5, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 05, 2017

15208 SE TIBBETTS ST, PORTLAND, OR 97236(503) 760-0959(503) 761-0041 Get Directions Write a Review

NPPES record last updated: September 5, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Durrell J Bolds NPPES

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

DURRELL J BOLDS (NPI 1366960890) is an individual mental health provider in Portland, Oregon and active in the NPI registry since September 2017.

NPI1366960890

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameDURRELL J BOLDS

Location Address15208 SE TIBBETTS STPortland, OR 97236-2356

Mailing Address3587 Heathrow WayMedford, OR 97504-4004 · (541) 858-8170 · Fax (541) 858-8167

Fax(503) 761-0041

Sole ProprietorNo

Enumeration DateSeptember 5, 2017

✔ NPI 1366960890 is a valid, active identifier and passes the ISO check-digit test.

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

15208 SE TIBBETTS ST, Portland, OR 97236

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

Counselor (Mental Health)