Provider Demographics
NPI:1952761215
Name:BAKER TO BAY PHYSICAL THERAPY AND WELLNESS P.S.
Entity Type:Organization
Organization Name:BAKER TO BAY PHYSICAL THERAPY AND WELLNESS P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:360-318-5478
Mailing Address - Street 1:10 LOUISE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-4419
Mailing Address - Country:US
Mailing Address - Phone:360-318-5478
Mailing Address - Fax:360-841-7683
Practice Address - Street 1:12 BELLWETHER WAY
Practice Address - Street 2:SUITE 232
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2959
Practice Address - Country:US
Practice Address - Phone:360-318-5478
Practice Address - Fax:360-841-7683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60244355261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy