Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD08914 | OR |
N | 207KA0200X | Allergist | MD08914 | OR |
NPI | 1710982293 |
---|---|
Provider Name | James W. Baker |
First Address | Portland, OR 97223-6683 |
Second Address | Portland, OR 97223-6683 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 28/07/2015 |