Provider Demographics
NPI:1821326539
Name:BAKER, CHRISTOPHER KENDRICK (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KENDRICK
Last Name:BAKER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 SE 20TH AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4991
Mailing Address - Country:US
Mailing Address - Phone:503-989-5361
Mailing Address - Fax:
Practice Address - Street 1:1550 SE 20TH AVE APT 306
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4991
Practice Address - Country:US
Practice Address - Phone:503-989-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200940994RN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program