MEDICARE: KATHY JO BAIER LMP

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	225700000X	Massage Therapist	MA00008053	WA

General Provider Information

NPI Number	:	1396836078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY JO BAIER LMP

Provider Business Mailing Address
First Line	:	2013 204TH ST SW
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-7028
Country	:	US
Telephone Number	:	425-771-5832
Fax Number	:

Provider Business Practice Location Address
First Line	:	21009 76TH AVE W
Second Line	:
City	:	EDMONDS
State	:	WA
Zip	:	98026-7126
Country	:	US
Telephone Number	:	425-672-2910
Fax Number	:	425-778-1872

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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Directions to “ KATHY JO BAIER LMP” Practice Location

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