Amanda Baker FNP-C, LLC

Organization Active NPI Family Nurse Practitioner · Deer Park, WA

NPI 1003563370 · NPPES record last updated Jul 10, 2024

Key facts

NPI
1003563370
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
Legal business name
AMANDA BAKER FNP-C, LLC
Practice address
23 E Crawford St
Deer Park, WA 99006-5432
Phone
(509) 485-4663
Fax
(833) 661-1784
NPI assigned
Mar 7, 2022
Organization subpart
No

Authorized official

Name
Amanda Baker, ARNP
Title
Owner
Phone
(509) 485-4663

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220517002398 WA Part B Supplier - Clinic/Group Practice 9638556442 Receives reassigned benefits from 1 practitioner
Practice locations: Deer Park, WA

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26015/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X Yes

Addresses

Primary practice location

23 E Crawford St
Deer Park, WA 99006-5432

Mailing address

PO Box 317
Elk, WA 99009-0317
Phone (509) 485-4663

Other providers in Deer Park, WA

All providers in Deer Park, WA · Family Nurse Practitioner in Washington

Sources for this page

Verify at the official NPI Registry.