Provider Demographics
NPI:1497896005
Name:BAKER, TAMARA L (RPT)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:L
Last Name:BAKER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 BELLEVUE WAY NE STE 8A856
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4280
Mailing Address - Country:US
Mailing Address - Phone:425-890-3989
Mailing Address - Fax:425-881-2312
Practice Address - Street 1:10001 NE 1ST ST APT W313
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5670
Practice Address - Country:US
Practice Address - Phone:425-890-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003899225100000X
2251X0800X
WAPT0003899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGO1291OtherBLUE SHIELD
000OtherNONE
WA68303OtherLABOR AND INDUSTRIES