Provider Demographics
NPI:1801020953
Name:BAILEY, JESSICA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ANNE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ANNE
Other - Last Name:HOSEASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD, CDRC-P
Mailing Address - Street 2:OREGON HEALTH & SCIENCE UNIVERSITY, DEPT OF PEDIATRICS
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-418-5170
Mailing Address - Fax:503-418-5337
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:OREGON HEALTH & SCIENCE UNIVERSITY, DEPT OF PEDIATRICS
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-418-5170
Practice Address - Fax:503-418-5337
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OR157562208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR157562OtherUNLIMITED MEDICAL LICENSE
OR157562OtherUNLIMITED MEDICAL LICENSE