Individual
MICHELLE ELIZABETH BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP, NCTMB
Contact information
Practice address
700 S MAIN ST, GRITMAN MEDICAL CENTER, MOSCOW, ID 83843-3056
(208) 883-6361
(208) 883-6452
Mailing address
600 RIDGE RD, MOSCOW, ID 83843-2690
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60231085
WA
Other
Enumeration date
06/16/2011
Last updated
06/16/2011
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