MEDICARE: JULIA BAKER DPT

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	225100000X	Physical Therapist	60908327	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT60908327	OTHER	WA	PT

General Provider Information

NPI Number	:	1770048118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA BAKER DPT

Provider Business Mailing Address
First Line	:	11601 N ASHLEY LN
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-2728
Country	:	US
Telephone Number	:	509-209-6287
Fax Number	:

Provider Business Practice Location Address
First Line	:	9651 N NEVADA ST STE 211
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-1132
Country	:	US
Telephone Number	:	509-270-0065
Fax Number	:	509-319-2520

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

Provider Enumeration Date	:	02/08/2019
Last Update Date	:	08/03/2020

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