Individual provider · Type 1 NPI

Jessica Lilliana Bautista, NP

Gerontology Nurse Practitioner · Portland, OR

NPI number 1184485492 Active

Practice location

9155 SW Barnes Rd Ste 238
Portland, OR 97225

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000X10020493 (OR)
Primary Care Nurse Practitioner 363LP2300X10020493 (OR)
Gerontology Nurse Practitioner Primary 363LG0600X10020493 (OR)

Gerontology Nurse Practitioner: Definition to come...

13 other providers at this address

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About NPI 1184485492

Jessica Lilliana Bautista, NP's National Provider Identifier is 1184485492, issued on Jan 23, 2024. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Portland, OR. The record was last updated on Aug 20, 2025.