Individual
DR. JOHN B BAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11307 BRIDGEPORT WAY SW STE 217, LAKEWOOD, WA 98499-3024
(253) 985-6134
(253) 985-6137
Mailing address
11307 BRIDGEPORT WAY SW STE 217, LAKEWOOD, WA 98499-3024
(253) 985-6134
(253) 985-6137
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD00044997
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0216025
STATE L&I
WA
01
—
0261681
STATE L&I
WA
01
—
0261684
STATE L&I
WA
01
—
0299315
STATE L&I
WA
05
—
7077449
—
WA
Enumeration date
08/02/2005
Last updated
11/24/2020
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