Individual
JENNIFER BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 331-6440
(503) 249-5286
Mailing address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 331-6440
(503) 249-5286
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD 26070
OR
208000000X
Pediatrics Physician
MD00045407
WA
Other
Enumeration date
08/23/2006
Last updated
07/08/2007
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