Provider Demographics
NPI:1790141893
Name:BAKER, RICHARD JAMES (BC-HIS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JAMES
Last Name:BAKER
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-6119
Mailing Address - Country:US
Mailing Address - Phone:360-532-2093
Mailing Address - Fax:
Practice Address - Street 1:309 W MARKET ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-6119
Practice Address - Country:US
Practice Address - Phone:360-532-2093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA00000821237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist