Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1780676734 Deactivated / Inactive NPI Male Practitioner

Dr. Bruce A Bouma , MD

Specialist • Spokane, WA

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Bruce Bouma has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 16, 2005
NPI Deactivation Date March 23, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Bruce Bouma, MD was a registered Specialist practicing in Spokane, WA. Throughout an active medical career spanning 1 years, Dr. Bouma provided care at the practice location at 235 E ROWAN AVE until profile deactivation on 2006-03-23.

Practice Location & Contact Primary Location

Practice Address

235 E Rowan Ave
204

Spokane, WA 992071240

Telephone 5093443100
Fax 5093443104
Associated Practice Facility / Clinic
🏢 Spokane Plastic Surgeons Ps Facility NPI 1134137599

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Spokane, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 35.4 Yrs
Regional Practice Density
108 Specialists

Practicing in Spokane, WA (2751 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License WA MD00019896

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
8322109 (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Tracy Berg , MD

Surgery - Vascular Surgery

NPI 1376637421

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location January 20, 2011

Registered at 235 E ROWAN AVE, 204, SPOKANE, WA 992071240 (Tel: 5093443100)

📍
Updated Business Mailing Address January 20, 2011

Registered at 235 E ROWAN AVE, 204, SPOKANE, WA 992071240 (Tel: 5093443100)

👤
Provider Name / Credentials Updated January 20, 2011

Recorded as BRUCE BOUMA, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 20, 2011

Specialist (License #MD00019896 in WA)

🔄
NPI Profile Reactivated March 27, 2006

Record officially reactivated for active practice on March 27, 2006

⚠️
NPI Profile Deactivated March 23, 2006

Record deactivated on March 23, 2006

🟢
Initial NPI Registration & Enumeration August 16, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Bruce Bouma. Be the first to share your experience!

Sign in to leave a review for Dr. Bruce Bouma

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1780676734
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 16, 2005
Last Update: January 20, 2011
Deactivation Date: March 23, 2006
Sole Proprietor: Yes

Mailing Address

235 E Rowan Ave, 204

Spokane, WA 992071240

Phone: 5093443100

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.