Provider Demographics
NPI:1811383821
Name:BAKER, MEGAN GERINGER (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:GERINGER
Last Name:BAKER
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 1:8645 SE SUNNYBROOK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-6841
Mailing Address - Country:US
Mailing Address - Phone:503-659-1694
Mailing Address - Fax:503-659-8984
Practice Address - Street 1:5050 NE HOYT ST STE B55
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2957
Practice Address - Country:US
Practice Address - Phone:503-233-5393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10083816-1205208000000X
390200000X
ORMD187499208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program