Provider Demographics
NPI:1265825897
Name:BAKER, VERLENE ROSE
Entity Type:Individual
Prefix:MRS
First Name:VERLENE
Middle Name:ROSE
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:VERLENE
Other - Middle Name:ROSE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1027 E. BURNSIDE ST.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214
Mailing Address - Country:US
Mailing Address - Phone:503-239-8400
Mailing Address - Fax:503-269-8407
Practice Address - Street 1:1030 NE COUCH ST.
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232
Practice Address - Country:US
Practice Address - Phone:503-239-8400
Practice Address - Fax:503-239-8407
Is Sole Proprietor?:No
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology