Individual
DERRICK BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6010 SW SHATTUCK RD, PORTLAND, OR 97221-1043
(503) 246-8811
Mailing address
6010 SW SHATTUCK RD, PORTLAND, OR 97221-1043
(503) 246-8811
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
285318
OR
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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