Individual
TARRA LEANI BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
1249 FAIRVIEW AVE SE, SALEM, OR 97302-2534
(971) 239-1146
Mailing address
PO BOX 4060, SALEM, OR 97302-1060
(971) 239-1146
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201701172RN
OR
163W00000X
Registered Nurse
210180
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201701173NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
21994
TN
Other
Enumeration date
08/27/2016
Last updated
03/03/2017
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