Provider Demographics
NPI:1114367810
Name:BAKER, LAURA LEE (RD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:BAKER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10330 MERIDIAN AVE N
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9451
Mailing Address - Country:US
Mailing Address - Phone:206-368-6123
Mailing Address - Fax:206-368-6178
Practice Address - Street 1:10330 MERIDIAN AVE N STE 250
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9441
Practice Address - Country:US
Practice Address - Phone:206-368-6123
Practice Address - Fax:206-368-6178
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001410133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered