Provider Demographics
NPI:1780305243
Name:BAKER, SYDNEY CAROL
Entity type:Individual
Prefix:MISS
First Name:SYDNEY
Middle Name:CAROL
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 PARK ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-4226
Mailing Address - Country:US
Mailing Address - Phone:503-328-4172
Mailing Address - Fax:
Practice Address - Street 1:300 BOULDER FALLS DR APT 117
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2881
Practice Address - Country:US
Practice Address - Phone:541-405-2049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker