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Contact Information

MARTIN E BUKOVSKY
155 NE WAX MYRTLE LOOP
YACHATS, OR97498-9427
 Phone: 541-351-5737
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

School

103TS0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MARTIN E BUKOVSKY · (Male)

NPI Number 1467124339
Status Active
Credentials
Entity Individual
Enumeration date 09/29/2021
Last updated 09/29/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 190058892
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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