Individual
DR. GENNADIY BAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 NE 99TH AVE STE 301, PORTLAND, OR 97220-9442
(503) 963-2707
(503) 963-2802
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD151230
OR
207RG0100X
Gastroenterology Physician
Primary
MD151230
OR
207RG0100X
Gastroenterology Physician
MD21774
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104016
—
MA
05
—
2157486
—
WA
05
—
500623274
—
OR
Enumeration date
10/26/2005
Last updated
02/26/2026
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