Provider Demographics
NPI:1831383157
Name:BAKER, ELISA L (HS)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:L
Last Name:BAKER
Suffix:
Gender:F
Credentials:HS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 SW 137TH ST BLDG 37
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1231
Mailing Address - Country:US
Mailing Address - Phone:360-480-6603
Mailing Address - Fax:
Practice Address - Street 1:1225 SW 137TH ST
Practice Address - Street 2:BLDG 37 APT # 443
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166
Practice Address - Country:US
Practice Address - Phone:360-480-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other