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General NPI Number Information
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NPI Number | 1225046352
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Entity Type | Individual
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Provider Name | ROY M. BAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 101 W 8TH AVE
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City | SPOKANE
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State | WA
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Zip | 99204-2307
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Country | US
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Telephone | 509-474-3181
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Fax | 509-598-2129
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Provider Business Mailing Address
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Address Line | 101 W 8TH AVE
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City | SPOKANE
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State | WA
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Zip | 99204-2307
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Country | US
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Telephone | 509-474-3181
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Fax | 509-598-2129
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 100064
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036-167022
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4127-320
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A79654
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD61096343
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License Number State | WA
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