Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CH00033960 | WA |
N | 111NX0100X | Occupational Health | 27 2853 | OR |
NPI | 1154542710 |
---|---|
Provider Name | Dr. Gregory Scott Baker |
First Address | Estacada, OR 97023 |
Second Address | Portland, OR 97206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |