Edward Ildoe Bae

NPI #1801226527 in Beaverton, Oregon

Provider Information

NPI Number: 1801226527
Entity Type: Organization
Organization Name: Edward Ildoe Bae
Primary Specialty: Community Health Worker
Enumeration Date: Nov 15, 2013
Last Updated: Feb 4, 2014

Practice Location

Address: 13755 SW FARMINGTON RD
City: Beaverton
State: Oregon
ZIP Code: 97005-2603
Phone: (503) 646-3743

Authorized Official

Name: EDWARD ILDOE BAE, L.AC.
Title: SOLE PROPRIETOR
Phone: (503) 646-3743

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X
Community Health Worker	172V00000X	Primary

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