Provider Demographics
NPI:1780935924
Name:BAKER, TRICIA J (PT MED)
Entity type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:J
Last Name:BAKER
Suffix:
Gender:F
Credentials:PT MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25022 170TH WAY SE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5258
Mailing Address - Country:US
Mailing Address - Phone:253-332-3619
Mailing Address - Fax:
Practice Address - Street 1:33330 8TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6325
Practice Address - Country:US
Practice Address - Phone:253-945-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 000022942251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics