Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DE00006659 | WA |
NPI | 1043240344 |
---|---|
Provider Name | Mrs. Irena M Baker |
First Address | Seattle, WA 98118-1658 |
Second Address | Seattle, WA 98118-1658 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 08/07/2007 |