1386169902 NPI number — CAROLINE HONG BAKER PHARMD

Table of content: CAROLINE HONG BAKER PHARMD (NPI 1386169902)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386169902 NPI number — CAROLINE HONG BAKER PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAKER
Provider First Name:
CAROLINE
Provider Middle Name:
HONG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HONG
Provider Other First Name:
CARLY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1386169902
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10712 SE CARR RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RENTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98055-5826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-277-1040
Provider Business Mailing Address Fax Number:
425-277-7935

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10712 SE CARR RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98055-5826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-277-1040
Provider Business Practice Location Address Fax Number:
425-277-7935
Provider Enumeration Date:
08/04/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RPH-0013336 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: PH60570288 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)