Provider Demographics
NPI:1093038614
Name:BAYNHAM, MARGARET ALLISON (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ALLISON
Last Name:BAYNHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ALLISON
Other - Last Name:MOORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7213 SW HAZEL FERN ROAD
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224
Mailing Address - Country:US
Mailing Address - Phone:503-214-2064
Mailing Address - Fax:503-598-3600
Practice Address - Street 1:7213 SW HAZELFERN RD
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-9722
Practice Address - Country:US
Practice Address - Phone:503-214-2064
Practice Address - Fax:503-598-3600
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD161650208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500657444Medicaid