Provider Demographics
NPI:1699841916
Name:BAKER, JOHN C (HIS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:BAKER
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7724 S PARWAY LN
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-8617
Mailing Address - Country:US
Mailing Address - Phone:509-747-2343
Mailing Address - Fax:
Practice Address - Street 1:9211 E MISSION AVE STE G
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4096
Practice Address - Country:US
Practice Address - Phone:509-323-9229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA#432237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist