Provider Demographics
NPI:1730599564
Name:BAIR, TERESA ERIN (DO)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ERIN
Last Name:BAIR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 NE HALSEY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-1540
Mailing Address - Country:US
Mailing Address - Phone:503-662-7226
Mailing Address - Fax:503-676-5662
Practice Address - Street 1:4275 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1540
Practice Address - Country:US
Practice Address - Phone:503-662-7226
Practice Address - Fax:503-676-5662
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO185316207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine