Provider Demographics
NPI:1164284352
Name:FOLLETT, BAYLI
Entity Type:Individual
Prefix:
First Name:BAYLI
Middle Name:
Last Name:FOLLETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ABBOTT RD
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-9336
Mailing Address - Country:US
Mailing Address - Phone:509-526-8674
Mailing Address - Fax:
Practice Address - Street 1:800 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-9336
Practice Address - Country:US
Practice Address - Phone:509-526-8674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG61498052390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program