Individual
AMIE BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1040 NW 22ND AVE # LL030, PORTLAND, OR 97210-3057
(502) 413-7702
Mailing address
PO BOX 3808, PORTLAND, OR 97208-3808
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA195888
OR
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/07/2019
Last updated
11/15/2019
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