Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT00005604 | WA |
N | 2251H1200X | Hand | PT00005604 | WA |
NPI | 1871537811 |
---|---|
Provider Name | Andelee Baker |
First Address | Burien, WA 98166-3003 |
Second Address | Burien, WA 98166-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 14/03/2013 |