Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD60099532 | WA |
NPI | 1245341106 |
---|---|
Provider Name | Bonnie V Baker |
First Address | Portland, OR 97208-3360 |
Second Address | Olympia, WA 98506-5133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 09/09/2019 |