Provider Demographics
NPI:1295823334
Name:BAIRD, HEIDI T (RD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:T
Last Name:BAIRD
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:PO BOX 469
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-0469
Mailing Address - Country:US
Mailing Address - Phone:509-482-2551
Mailing Address - Fax:509-482-1857
Practice Address - Street 1:601 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3825
Practice Address - Country:US
Practice Address - Phone:509-482-2551
Practice Address - Fax:509-482-1857
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001895133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00384895OtherRAILROAD MEDICARE
WA7122724Medicaid
WAP00384895OtherRAILROAD MEDICARE