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BETHANY TARA SAMUELSON BANNOW MD NPI 1619267556


NPI Information

NPI: 1619267556
Provider Name: BETHANY TARA SAMUELSON BANNOW, MD
Classification: Internal Medicine - 207RH0000X
Entity Type: Individual

Specialization: Hematology

PECOS Registration: Yes

Address:
3303 SW BOND AVE
PORTLAND, OR
ZIP 97239
Phone: (503) 494-8534
Get Directions

Bethany Tara Samuelson Bannow, MD is a hematology internal medicine in Portland, OR. The provider is an internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma. Bethany Tara Samuelson Bannow, MD NPI is 1619267556. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3303 SW BOND AVE
PORTLAND, OR
ZIP 97239-501
Phone: (503) 494-8534

The NPI 1619267556 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/12/2011 and was last updated on 3/17/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & OncologyMD60469202WASHINGTONNo
2207RH0000XInternal MedicineHematologyOR186355OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.