Provider Demographics
NPI:1184126559
Name:TORREZ, BAILEY NICOLE
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:NICOLE
Last Name:TORREZ
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 1:1753 NE 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2009
Mailing Address - Country:US
Mailing Address - Phone:775-843-5135
Mailing Address - Fax:
Practice Address - Street 1:1844 SW MORRISON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1605
Practice Address - Country:US
Practice Address - Phone:775-843-5135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer