| Kristy Baker Psyd Llc | |
|
22344 Sw Main St Sherwood OR 97140-9416 | |
| (503) 625-2768 | |
| Not Available |
| Full Name | Kristy Baker Psyd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 22344 Sw Main St, Sherwood, Oregon |
| Authorized Official Name and Position | Kristy Baker (OWNER) |
| Authorized Official Contact | 5036252768 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristy Baker Psyd Llc 22344 Sw Main St Sherwood OR 97140-9416 Ph: () - | Kristy Baker Psyd Llc 22344 Sw Main St Sherwood OR 97140-9416 Ph: (503) 625-2768 |
| NPI Number | 1861116873 |
|---|---|
| Provider Enumeration Date | 10/03/2022 |
| Last Update Date | 10/03/2022 |
| Certification Date | 10/03/2022 |
| Medicare PECOS PAC ID | 6305215492 |
|---|---|
| Medicare Enrollment ID | O20221212002947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861116873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristy Psyd Baker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770780579 PECOS PAC ID: 8224408885 Enrollment ID: I20230120002260 |
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