Provider Demographics
NPI:1164562930
Name:BAKER, EMMA (ND)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8718
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-8718
Mailing Address - Country:US
Mailing Address - Phone:541-788-7650
Mailing Address - Fax:
Practice Address - Street 1:1045 NW BOND ST STE 204
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2043
Practice Address - Country:US
Practice Address - Phone:541-322-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1216175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath