Bautista, Ellen Priscilla Saqueton
Bautista, Ellen Priscilla Saqueton is an individual health care provider with primary practice located at 1003 Providence Dr Suite 210, Newberg OR 97132-7521. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Bautista, Ellen Priscilla Saqueton can be contacted via phone (503) 537-5900.Contact Information
Primary practice address
1003 Providence Dr Suite 210
Newberg OR 97132-7521
Phone: (503) 537-5900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 125052040 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD126320 | Oregon |
Profile Details
| NPI number | 1174744395 |
|---|---|
| LBN Legal business name | Bautista, Ellen Priscilla Saqueton |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2007 |
| Last updated | Oct 13th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174744395 | NPPES |
| Oregon | MEDICAID | 500614683 | |
| Oregon | Other | P01034673 |
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