Provider Demographics
NPI:1407031313
Name:BAKER, STEPHANIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:BAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15655 NE 85TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3563
Mailing Address - Country:US
Mailing Address - Phone:425-881-3100
Mailing Address - Fax:425-881-3102
Practice Address - Street 1:15655 NE 85TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3563
Practice Address - Country:US
Practice Address - Phone:425-881-3100
Practice Address - Fax:425-881-3102
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036626207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine