Alexis Kari Bagwell, MD
Student in an Organized Health Care Education/Training Program in Portland, OR. Individual provider (NPI-1).
NPI number1861997447
StatusActive
Last updated in NPPESMar 27, 2018
Details
- NPI
- 1861997447
- Entity type
- Individual (NPI-1)
- Name
- Alexis Kari Bagwell
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2018
- Last updated
- Mar 27, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
3181 Sw Sam Jackson Park Rd # L-579Portland, OR 97239-3098
Phone 503-494-8211
Mailing address
3181 Sw Sam Jackson Park Rd # L-579Portland, OR 97239-3098
Phone 503-494-8211
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