MEDICARE: MR. JOHN C BAKER HIS

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	237700000X	Hearing Instrument Specialist	#432	WA

General Provider Information

NPI Number	:	1699841916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN C BAKER HIS

Provider Business Mailing Address
First Line	:	7724 S PARWAY LN
Second Line	:
City	:	CHENEY
State	:	WA
Zip	:	99004-8617
Country	:	US
Telephone Number	:	509-747-2343
Fax Number	:

Provider Business Practice Location Address
First Line	:	9211 E MISSION AVE STE G
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-4096
Country	:	US
Telephone Number	:	509-323-9229
Fax Number	:

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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