=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316168404
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. CHRISTINA L. BAUER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 142 B ST
-----------------------------------------------------
City | ASHLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97520-1911
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-941-7600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 434 COURTNEY ST
-----------------------------------------------------
City | ASHLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97520-3014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 547-194-7600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 9040
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------