Provider Demographics
NPI:1871595439
Name:BIX, NADJA DESIREE (MD)
Entity type:Individual
Prefix:
First Name:NADJA
Middle Name:DESIREE
Last Name:BIX
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 1:200 SW MARKET ST STE 1650
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5739
Mailing Address - Country:US
Mailing Address - Phone:503-466-1668
Mailing Address - Fax:503-439-6194
Practice Address - Street 1:1130 NW 22ND AVE STE 320
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2970
Practice Address - Country:US
Practice Address - Phone:503-295-2546
Practice Address - Fax:503-790-1248
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD19410208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR073135Medicaid
OR073135Medicaid
G15797Medicare UPIN