ALEXANDER BAUTISTA
Individual Provider (NPI-1)
Active
Registered Nurse
Provider Information
- NPI Number
1346073863- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 4101 NE DIVISION ST, GRESHAM, OR, 970304617
- Phone
- (503) 666-6575
Specialties & Taxonomies
Registered Nurse
Primary License: OR #200640866RN
All Addresses
MAILING
4101 NE DIVISION ST
GRESHAM, OR, 970304617