Organization
TACOMA DIGESTIVE DISEASE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD D BAERG MD (MEDICAL DIRECTOR)
(253) 272-8664
Entity
Organization
Contact information
Practice address
1112 6TH AVE, 200, TACOMA, WA 98405-4040
(253) 272-8664
(253) 404-1352
Mailing address
1112 6TH AVE, 200, TACOMA, WA 98405-4040
(253) 272-8664
(253) 404-1352
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0077665
LABOR & INDUSTRIES
WA
05
—
7079247
—
WA
01
—
CD9272
RAILROAD MEDICARE
—
01
—
P07414
REGENCE BLUE SHIELD
—
Enumeration date
06/25/2006
Last updated
08/22/2020
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