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Individual

MICHAEL BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
114 SE CHURCH ST, SUBLIMITY, OR 97385-9424
(503) 769-2259
(503) 769-8049
Mailing address
PO BOX 886, SUBLIMITY, OR 97385-0886
(503) 769-2259
(503) 769-8049

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006828
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50.006828
OHIO MEDICAL BOARD
OH
Enumeration date
01/14/2021
Last updated
05/18/2021
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