Provider Demographics
NPI:1023766847
Name:BAYLES, JAMES (LPTA, CPT, SF)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BAYLES
Suffix:
Gender:M
Credentials:LPTA, CPT, SF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 NE HOGAN DR #300 STE E
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3173
Mailing Address - Country:US
Mailing Address - Phone:503-806-1663
Mailing Address - Fax:
Practice Address - Street 1:39 NE 102ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4103
Practice Address - Country:US
Practice Address - Phone:503-252-2461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8512225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant