Provider Demographics
NPI:1023185683
Name:BAKER, DEBORAH D (LMP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:D
Last Name:BAKER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:14908 26TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5768
Mailing Address - Country:US
Mailing Address - Phone:425-424-3730
Mailing Address - Fax:425-424-2371
Practice Address - Street 1:18920 BOTHELL WAY NE
Practice Address - Street 2:SUITE 204
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-1981
Practice Address - Country:US
Practice Address - Phone:425-424-3730
Practice Address - Fax:425-424-2371
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA17604225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist