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Individual

MARK GARDNER BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15950 SW MILLIKAN WAY, BEAVERTON, OR 97006
(503) 646-0161
(503) 643-7459
Mailing address
15950 SW MILLIKAN WAY, BEAVERTON, OR 97006
(503) 646-0161
(503) 643-7459

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD24179
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
227373
OR
Enumeration date
09/28/2006
Last updated
10/19/2020
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