Provider Demographics
NPI:1285229765
Name:BAIR BONES OSTEOPATHIC FAMILY MEDICINE INC
Entity Type:Organization
Organization Name:BAIR BONES OSTEOPATHIC FAMILY MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:BAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-662-7226
Mailing Address - Street 1:3519 NE 15TH AVE # 429
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2356
Mailing Address - Country:US
Mailing Address - Phone:503-662-7226
Mailing Address - Fax:
Practice Address - Street 1:2505 SE 11TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1061
Practice Address - Country:US
Practice Address - Phone:503-662-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty