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General NPI Number Information
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NPI Number | 1104753805
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Entity Type | Organization
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Legal Business Name | BAKER SHETTY
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 17234 140TH AVE SE
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City | RENTON
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State | WA
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Zip | 98058-7014
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Country | US
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Telephone | 425-523-1699
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Fax |
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Provider Business Mailing Address
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Address Line | 17234 140TH AVE SE
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City | RENTON
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State | WA
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Zip | 98058-7014
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JAY MICHAEL BAKER
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Credential |
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Telephone | 425-523-1699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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