Provider Demographics
NPI:1396594610
Name:BAXTER, HANAKO
Entity type:Individual
Prefix:
First Name:HANAKO
Middle Name:
Last Name:BAXTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HANAKO
Other - Middle Name:KUMEDA
Other - Last Name:HIGHSMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 E MCLOUGHLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3358
Mailing Address - Country:US
Mailing Address - Phone:360-281-6824
Mailing Address - Fax:
Practice Address - Street 1:601 E MCLOUGHLIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3358
Practice Address - Country:US
Practice Address - Phone:360-281-6824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program