Healthcare Provider Details

I. General information

NPI: 1780970251
Provider Name (Legal Business Name): EMILY C BALTES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11511 NE 10TH ST
BELLEVUE WA
98004-8578
US

IV. Provider business mailing address

11511 NE 10TH ST
BELLEVUE WA
98004-8578
US

V. Phone/Fax

Practice location:
  • Phone: 425-502-3000
  • Fax: 844-620-1839
Mailing address:
  • Phone: 425-502-3000
  • Fax: 844-620-1839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number01076052A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD60828364
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: