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General NPI Number Information
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NPI Number | 1497781355
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Entity Type | Individual
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Provider Name | PHILLIP D BAKER MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 1015 NW 22ND AVE STE T240
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City | PORTLAND
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State | OR
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Zip | 97210-3025
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Country | US
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Telephone | 503-413-7127
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Fax | 503-227-0218
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Provider Business Mailing Address
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Address Line | 1015 NW 22ND AVE
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City | PORTLAND
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State | OR
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Zip | 97210-3025
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Country | US
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Telephone |
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Fax |
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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 | MD18935
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License Number State | OR
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