Nicole Layne Baker
Individual provider Active NPI Physical Therapist · Longview, WA
NPI 1619622776 · NPPES record last updated Dec 4, 2023
Key facts
- NPI
- 1619622776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 200 Triangle Shopping Ctr Ste 270
Longview, WA 98632-4684 - Phone
- (360) 501-3750
- NPI assigned
- Feb 17, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Peacehealth
Practice addresses (Care Compare)
200 Triangle Ctr
Suite 270
Longview, WA 98632-4098
Phone (360) 501-3750
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220325000903 | WA | Practitioner - Physical Therapist in Private Practice | 5991190175 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Current |
Accepting new patients | |
| Peacehealth | Physical Therapist | Past | Accepting new patients |
Locations
1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818
200 Triangle Shopping Ctr
Ste 270
Longview, WA 98632
Phone (360) 501-3750
1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
200 Triangle Shopping Ctr Ste 270
Longview, WA 98632-4684
Mailing address
253 Chapman Rd
Castle Rock, WA 98611-9658
Phone (360) 749-7497
Other names
- Nicole Seidl
Other providers in Longview, WA
- Sholeh Bagheri
- Suhail Bahu
- Kelly Baierl
- Gerry Lee Bailey
- Amanda Elaine Baker
- Sadie Baker
- Tabitha L Baldwin
- Malea Ball
- Karyn Banke
- Elijah Allan Jackson Bannister
All providers in Longview, WA · Physical Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.