NPI 1770780579 · live from the CMS NPI Registry
Kristy R Baker, Psy.D
Psychologist, Clinical in Portland, OR. National Provider Identifier 1770780579, active.
NPI record
| NPI | 1770780579 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 516 Se Morrison St, Suite 650, Portland, OR 97214 |
| Practice phone | 503-449-9595 |
| Mailing address | 22809 Sw Main St, Sherwood, OR 97140 |
| Enumerated | June 27, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | 1747 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.