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General NPI Number Information
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NPI Number | 1689786832
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Entity Type | Individual
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Provider Name | ERIK G BATES PA
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 2020 CAPITOL ST NE
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City | SALEM
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State | OR
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Zip | 97301-0644
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Country | US
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Telephone | 503-399-2475
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Fax | 503-375-7454
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Provider Business Mailing Address
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Address Line | 2020 CAPITOL ST NE PO BOX 8100
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City | SALEM
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State | OR
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Zip | 97301-0644
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Country | US
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Telephone | 503-399-2475
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Fax | 503-375-7454
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA10003991
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License Number State | WA
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