Provider Demographics
NPI:1386198588
Name:BAXTER, JENNIFER (AAHCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BAXTER
Suffix:
Gender:F
Credentials:AAHCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 S SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2816
Mailing Address - Country:US
Mailing Address - Phone:253-208-7359
Mailing Address - Fax:
Practice Address - Street 1:2351 S SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2816
Practice Address - Country:US
Practice Address - Phone:253-208-7359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator