Healthcare Provider Details

I. General information

NPI: 1982542726
Provider Name (Legal Business Name): BAIK AND SONG PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 E MAIN ST STE 201
MONROE WA
98272-1528
US

IV. Provider business mailing address

267 E MAIN ST STE 201
MONROE WA
98272-1528
US

V. Phone/Fax

Practice location:
  • Phone: 360-794-0717
  • Fax:
Mailing address:
  • Phone: 360-794-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DOOSU BAIK
Title or Position: OWNER
Credential:
Phone: 360-794-0717