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NPI Code Detail

MEDICARE: ANNE-MARIE BATH MCCOY MD

MEDICARE: ANNE-MARIE BATH MCCOY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00042162WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P00019803OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10170505OTHERWALABOR & IND.
28932195OTHERWACRIME VICTIMS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720085475
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE-MARIE BATH MCCOY MD
Provider Business Mailing Address
First Line : 500 NE MULTNOMAH ST STE 100
Second Line :
City : PORTLAND
State : OR
Zip : 97232-2099
Country : US
Telephone Number : 800-813-2000
Fax Number :
Provider Business Practice Location Address
First Line : 12607 SE MILL PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98684-6055
Country : US
Telephone Number : 800-813-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 01/08/2026

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Directions to “ ANNE-MARIE BATH MCCOY MD” Practice Location

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