Provider Demographics
NPI:1669962692
Name:BAIDE, ANASTASIA MARIE (RPH)
Entity type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:MARIE
Last Name:BAIDE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14027 LAKE CITY WAY NE APT E303
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3859
Mailing Address - Country:US
Mailing Address - Phone:406-491-5085
Mailing Address - Fax:
Practice Address - Street 1:851 MOORE ST
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-1238
Practice Address - Country:US
Practice Address - Phone:360-856-2153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60781620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist