MEDICARE: SERENA LEE BAAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	HA00002620	WA

General Provider Information

NPI Number	:	1598072266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENA LEE BAAR

Provider Business Mailing Address
First Line	:	4502 S STEELE ST
Second Line	:	SUITE 100
City	:	TACOMA
State	:	WA
Zip	:	98409-7242
Country	:	US
Telephone Number	:	253-472-1693
Fax Number	:	253-471-2198

Provider Business Practice Location Address
First Line	:	4502 S STEELE ST
Second Line	:	SUITE 100
City	:	TACOMA
State	:	WA
Zip	:	98409-7242
Country	:	US
Telephone Number	:	253-472-1693
Fax Number	:	253-471-2198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	09/01/2010

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Directions to “ SERENA LEE BAAR ” Practice Location

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