Provider Demographics
NPI:1770253080
Name:BAKER, AUSTIN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:AUSTIN
Other - Middle Name:G
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:731 CONCONULLY RD
Mailing Address - Street 2:
Mailing Address - City:OKANOGAN
Mailing Address - State:WA
Mailing Address - Zip Code:98840-9716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 E DEWBERRY AVE
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9543
Practice Address - Country:US
Practice Address - Phone:509-429-6887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60868373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist