Individual
ANNAMARIE BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1321 NE 99TH AVE, STE 100, PORTLAND, OR 97220-9437
(503) 215-9900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200950020NP
OR
363LN0000X
Neonatal Nurse Practitioner
200250129NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500612848
—
OR
Enumeration date
09/19/2008
Last updated
01/09/2012
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