Provider Demographics
NPI:1952583957
Name:BAKER, TARRAH MARGARET (MS SLPCCC)
Entity Type:Individual
Prefix:MRS
First Name:TARRAH
Middle Name:MARGARET
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS SLPCCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:WALLOWA
Mailing Address - State:OR
Mailing Address - Zip Code:97885-0187
Mailing Address - Country:US
Mailing Address - Phone:541-886-3302
Mailing Address - Fax:541-886-3300
Practice Address - Street 1:75167 LOWER DIAMOND LN
Practice Address - Street 2:
Practice Address - City:WALLOWA
Practice Address - State:OR
Practice Address - Zip Code:97885-8167
Practice Address - Country:US
Practice Address - Phone:541-886-3302
Practice Address - Fax:541-886-3300
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist