NPI 1336043538 · live from the CMS NPI Registry
Marissa Bulder
Audiologist in Portland, OR. National Provider Identifier 1336043538, active.
NPI record
| NPI | 1336043538 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 2230 Nw Pettygrove St, Portland, OR 97210 |
| Practice phone | 503-444-7676 |
| Mailing address | 15900 Ne 194th Ct, Brush Prairie, WA 98606 |
| Enumerated | October 3, 2026 |
| Last updated | October 3, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist primary | 231H00000X | 31180 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.