Individual
JESSICA LILLIANA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9155 SW BARNES RD STE 238, PORTLAND, OR 97225
(503) 215-9297
Mailing address
9155 SW BARNES RD STE 238, PORTLAND, OR 97225-6629
(503) 215-9297
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10020493
OR
363LG0600X
Gerontology Nurse Practitioner
Primary
10020493
OR
363LP2300X
Primary Care Nurse Practitioner
10020493
OR
Other
Enumeration date
01/23/2024
Last updated
08/20/2025
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