Provider Demographics
NPI:1437241601
Name:BITTS, LAURA KAY (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:BITTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6640 SW REDWOOD LANE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97224
Mailing Address - Country:US
Mailing Address - Phone:503-620-7358
Mailing Address - Fax:503-624-6144
Practice Address - Street 1:6640 SW REDWOOD LANE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97224
Practice Address - Country:US
Practice Address - Phone:503-620-7358
Practice Address - Fax:503-624-6144
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24318207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR227374Medicaid
117508Medicare ID - Type Unspecified
G16024Medicare UPIN