Basic Information
| Provider Information | |||||||||
| NPI: | 1891068169 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAAR | ||||||||
| FirstName: | FATIMA | ||||||||
| MiddleName: | JANETH | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 568 | ||||||||
| Address2: | |||||||||
| City: | CORNELIUS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971130568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033528657 | ||||||||
| FaxNumber: | 5033528658 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 NE MAY LN | ||||||||
| Address2: | |||||||||
| City: | MCMINNVILLE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971289272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034721338 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2012 | ||||||||
| LastUpdateDate: | 10/05/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.