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General NPI Number Information
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NPI Number | 1952381733
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Entity Type | Individual
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Provider Name | CARLA J BAUMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 07/17/2020
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Provider Practice Location Address
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Address Line | 626 120TH AVE NE STE B104
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City | BELLEVUE
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State | WA
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Zip | 98005-3077
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Country | US
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Telephone | 425-455-3376
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Fax | 425-455-2766
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Provider Business Mailing Address
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Address Line | 3277 84TH AVE SE
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City | MERCER ISLAND
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State | WA
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Zip | 98040-3017
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Country | US
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Telephone | 206-275-3476
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD00033024
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License Number State | WA
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