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Individual

PHILLIP D BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1015 NW 22ND AVE, STE T240, PORTLAND, OR 97210-3025
(503) 413-7127
(503) 227-0218
Mailing address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD18935
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
028036012
BCBS REGENCE
OR
05
130068
OR
01
P00282471
RAILROAD MEDICARE
OR
Enumeration date
06/23/2006
Last updated
07/31/2025
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