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General NPI Number Information
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NPI Number | 1366092652
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Entity Type | Individual
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Provider Name | CHAR M BAKER LMT
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Gender | Female
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 281 W OREGON AVE RM 2
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City | CRESWELL
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State | OR
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Zip | 97426-9605
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Country | US
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Telephone | 541-525-0613
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 515
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City | PLEASANT HILL
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State | OR
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Zip | 97455-0515
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Country | US
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Telephone | 541-525-0613
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 25183
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License Number State | OR
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