Provider Demographics
NPI:1033516620
Name:BAKER, JANINE LEE (PHARMD, BCGP)
Entity Type:Individual
Prefix:DR
First Name:JANINE
Middle Name:LEE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARMD, BCGP
Other - Prefix:DR
Other - First Name:JEN
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD, BCGP
Mailing Address - Street 1:2326 MARINA DR
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-9110
Mailing Address - Country:US
Mailing Address - Phone:541-591-8480
Mailing Address - Fax:
Practice Address - Street 1:2225 N ELDORADO AVE
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-6417
Practice Address - Country:US
Practice Address - Phone:541-273-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0014414183500000X, 1835P0018X
OR991081121835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric