Emilia C Bazan-Grow

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

EMILIA C BAZAN-GROW

Practice address

13235 SW Glenhaven St
Beaverton, OR 97005-0958

Phone

(503) 750-4937

Fax

(503) 746-7445

NPI assigned

Feb 11, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Emilia Bazan-Grow

Title

Owner

Phone

(503) 750-4937

Specialties & licenses 1

Addresses

Other names 1

• Pacific Coast Geriatrics Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1770175671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13235 SW GLENHAVEN ST",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970050958",
            "telephone_number": "503-750-4937",
            "fax_number": "503-746-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13235 SW GLENHAVEN ST",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970050958",
            "telephone_number": "503-750-4937",
            "fax_number": "503-746-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMILIA C BAZAN-GROW",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "BAZAN-GROW",
        "authorized_official_first_name": "EMILIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-750-4937"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Coast Geriatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Nurse Practitioner in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.