Provider Demographics
NPI:1619128485
Name:BAKER, KATIE B (ND, LMP)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:B
Last Name:BAKER
Suffix:
Gender:F
Credentials:ND, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6204 8TH AVE NW STE B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2270
Mailing Address - Country:US
Mailing Address - Phone:206-355-4309
Mailing Address - Fax:206-297-6325
Practice Address - Street 1:6204 8TH AVE NW STE B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-2270
Practice Address - Country:US
Practice Address - Phone:206-355-4309
Practice Address - Fax:206-297-6325
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60043530175F00000X
WAMA00025272225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0241144OtherWA STATE L&I NUMBER