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NPI Code Detail

MEDICARE: JENYLYN TERESE BAURES MSW

MEDICARE: JENYLYN TERESE BAURES MSW
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1790864890
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENYLYN TERESE BAURES MSW
Provider Business Mailing Address
First Line : 4256 SW CORBETT AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4259
Country : US
Telephone Number : 541-515-1577
Fax Number :
Provider Business Practice Location Address
First Line : 3710 SW US VETERANS HOSPITAL RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-2964
Country : US
Telephone Number : 503-220-8262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 07/08/2007

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Directions to “ JENYLYN TERESE BAURES MSW” Practice Location

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