| Doctor Name: | MARGOT R BOLSTAD |
| NPI Number: | 1124082458 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DO |
| License Number: | DO14331 |
| Business Practice Address: | 1620 E 12th St The Dalles, OR - 97058 |
| Business Phone Number: | 5412969151 |
| Business Fax Number: | 5412964710 |
| Mailing Address: | 1620 E 12th St, Po Box 1520 THE DALLES |
| State: | OR |
| Postal Code: | 97058 |
| Phone Number: | 5412969151 |
| Fax Number: | 5412964710 |
| NPI Enumeration Date: | 04/13/2006 |
| NPI Last Update Date: | 02/03/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | DO14331 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |