NPI 1851421374 · live from the CMS NPI Registry
Bert Manfred Baker, PA-C
Physician Assistant in Tacoma, WA. National Provider Identifier 1851421374, active.
NPI record
| NPI | 1851421374 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431 |
| Practice phone | 253-968-2252 |
| Mailing address | 4141 S Staples St, Ste 300, Corpus Christi, TX 78411 |
| Enumerated | March 6, 2007 |
| Last updated | May 18, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | PA02190 (TX) |
| Physician Assistant primary | 363A00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.