Healthcare Provider Details

I. General information

NPI: 1477649036
Provider Name (Legal Business Name): CARMEN KIMBERLY BAKER HUDSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARMEN KIMBERLY BAKER M.D.

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16233 SYLVESTER RD SW STE G60
BURIEN WA
98166-3047
US

IV. Provider business mailing address

16233 SYLVESTER RD SW STE G60
BURIEN WA
98166-3047
US

V. Phone/Fax

Practice location:
  • Phone: 206-988-5724
  • Fax: 206-241-4430
Mailing address:
  • Phone: 206-988-5724
  • Fax: 206-241-4430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberM14637
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number11250182-1205
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD60076645
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberT4936
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD187023
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: