MEDICARE: DR. LISA K BAIRD PHARM.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	1835P1200X	Pharmacotherapy Pharmacist	PH 48170	WA

General Provider Information

NPI Number	:	1598753683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA K BAIRD PHARM.D.

Provider Business Mailing Address
First Line	:	1161 BUNGE RD
Second Line	:
City	:	ELK
State	:	WA
Zip	:	99009-8502
Country	:	US
Telephone Number	:	509-292-5252
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 N LIDGERWOOD ST
Second Line	:	SUITE 128
City	:	SPOKANE
State	:	WA
Zip	:	99208-1122
Country	:	US
Telephone Number	:	509-482-3057
Fax Number	:	509-482-3058

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	07/08/2007

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