Individual
KAYLYNN M BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CG
Contact information
Practice address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 684-5286
Mailing address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 684-5286
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60859353
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CG60859353
WA
Other
Enumeration date
10/19/2018
Last updated
01/22/2019
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