Individual
BRADLEY EUGENE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-3882
(503) 413-2093
Mailing address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-3882
(503) 413-2093
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD28119
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD28119
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD28119
OREGON MEDICAL LICENSE
OR
Enumeration date
05/28/2008
Last updated
05/28/2008
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