Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT00007077 | WA |
N | 2251N0400X | Physical Therapist - Neurology | PT00007077 | WA |
N | 2251S0007X | Physical Therapist - Sports | PT00007077 | WA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT00007077 | WA |
NPI | 1174586234 |
---|---|
Provider Name | Gretchen Elizabeth Baker-Bold |
First Address | Everett, WA 98201-1004 |
Second Address | Everett, WA 98201-2879 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 09/12/2020 |