Edward Ildoe Bae

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

EDWARD ILDOE BAE

Practice address

13755 SW Farmington Rd
Beaverton, OR 97005-2603

Phone

(503) 646-3743

Fax

(503) 646-5200

NPI assigned

Nov 15, 2013

Organization subpart

No

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

Authorized official

Name

Edward Ildoe Bae, L.AC.

Title

Sole Proprietor

Phone

(503) 646-3743

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1801226527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13755 SW FARMINGTON RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052603",
            "telephone_number": "503-646-3743",
            "fax_number": "503-646-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13755 SW FARMINGTON RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052603",
            "telephone_number": "503-646-3743",
            "fax_number": "503-646-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD ILDOE BAE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "BAE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "ILDOE",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "503-646-3743",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00115",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Ebersole
• Annmarie Eby
• Ka' Rita Eddings, MA
• Edmund H. Torkelson DO, PC
• Jeannie Edney
• Laura A Edwards-Leeper, PH.D.
• Candace Dawn Edwards
• Daniel Edwards
• Jasper Edwards
• Marnie Edwards

• Community Health Worker in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Community Health Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.