Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD154995 | OR |
NPI | 1558533273 |
---|---|
Provider Name | Dr. Adam Parks Baker |
First Address | Portland, OR 97216-2469 |
Second Address | Portland, OR 97216-2469 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2008 |
Last Update Date | 09/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500654149 | (05) | OR |