Provider Demographics
NPI:1962015842
Name:CURL, BAYLI LAINE
Entity Type:Individual
Prefix:
First Name:BAYLI
Middle Name:LAINE
Last Name:CURL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 SE HARRISON ST APT C7
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-6555
Mailing Address - Country:US
Mailing Address - Phone:503-956-9686
Mailing Address - Fax:
Practice Address - Street 1:3430 SE HARRISON ST APT C7
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6555
Practice Address - Country:US
Practice Address - Phone:503-956-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR108722Medicaid