Healthcare Provider Details

I. General information

NPI: 1891625562
Provider Name (Legal Business Name): EULOGIA ELAINE BAADER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELLIE BAADER DO

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 6TH AVE STE 301
TACOMA WA
98405-4048
US

IV. Provider business mailing address

6415 VISTA DR
FERNDALE WA
98248-9674
US

V. Phone/Fax

Practice location:
  • Phone: 360-441-2081
  • Fax:
Mailing address:
  • Phone: 360-441-2081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberWDL4SZP3G43B
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: