Individual
SHAYNE NICOLE WILLIS BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC, CIMT
Contact information
Practice address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-3151
Mailing address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-3151
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5021
OR
Other
Enumeration date
02/18/2009
Last updated
06/07/2020
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