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General NPI Number Information
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NPI Number | 1326029950
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Entity Type | Individual
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Provider Name | JASON RICHARD BAUER MD
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Gender | Male
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 25030 SW PARKWAY AVE STE 200
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City | WILSONVILLE
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State | OR
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Zip | 97070-9816
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Country | US
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Telephone | 503-612-0498
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Fax | 503-459-0521
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Provider Business Mailing Address
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Address Line | 25030 SW PARKWAY AVE STE 200
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City | WILSONVILLE
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State | OR
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Zip | 97070-9816
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Country | US
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Telephone | 503-612-0498
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Fax | 503-459-0521
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD26590
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 3067
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 76385
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MD26590
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | MD26590
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License Number State | OR
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