Provider Demographics
NPI:1710288782
Name:BAKER, AMY C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:C
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 PARK RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1695
Mailing Address - Country:US
Mailing Address - Phone:505-400-3122
Mailing Address - Fax:
Practice Address - Street 1:11 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7337
Practice Address - Country:US
Practice Address - Phone:541-200-6859
Practice Address - Fax:541-842-7637
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00140191835P0018X, 183500000X
NMRP00007803183500000X
WAPH60229480183500000X
HIPH-3118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist