Provider Demographics
NPI:1356634661
Name:BAKER, MARGARET ELIZABETH (FNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:BAKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6464 SW BORLAND RD STE A2
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8854
Mailing Address - Country:US
Mailing Address - Phone:503-885-1515
Mailing Address - Fax:503-885-1520
Practice Address - Street 1:6464 SW BORLAND RD STE A2
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8854
Practice Address - Country:US
Practice Address - Phone:503-885-1515
Practice Address - Fax:503-885-1520
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OR201394533NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500670071Medicaid
WA1356634661Medicaid
ORP01416416Medicare PIN
WA1356634661Medicaid