Provider Demographics
NPI:1780823112
Name:BAIRD MEDICAL SERVICES P.C.
Entity Type:Organization
Organization Name:BAIRD MEDICAL SERVICES P.C.
Other - Org Name:LIVING ENHANCEMENT INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-434-8021
Mailing Address - Street 1:2929 SW MULTNOMAH BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-4025
Mailing Address - Country:US
Mailing Address - Phone:877-434-8021
Mailing Address - Fax:503-954-2041
Practice Address - Street 1:2929 SW MULTNOMAH BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-4025
Practice Address - Country:US
Practice Address - Phone:877-434-8021
Practice Address - Fax:503-954-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORBB261109261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center