MEDICARE: VICTORIA ANN BAKER-HALL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD00024221	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386630820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA ANN BAKER-HALL M.D.

Provider Business Mailing Address
First Line	:	615 W STEVENS AVE
Second Line	:
City	:	SULTAN
State	:	WA
Zip	:	98294-9458
Country	:	US
Telephone Number	:	360-793-0201
Fax Number	:	360-793-2429

Provider Business Practice Location Address
First Line	:	615 W STEVENS AVE
Second Line	:
City	:	SULTAN
State	:	WA
Zip	:	98294-9458
Country	:	US
Telephone Number	:	360-793-0201
Fax Number	:	360-793-2429

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	01/03/2011

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Directions to “ VICTORIA ANN BAKER-HALL M.D.” Practice Location

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