Provider Demographics
NPI:1063403897
Name:BAUMEISTER, TODD JOHN (DO)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:JOHN
Last Name:BAUMEISTER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:7500 212TH ST SW
Mailing Address - Street 2:SUITE 212
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7641
Mailing Address - Country:US
Mailing Address - Phone:425-744-6022
Mailing Address - Fax:425-744-0631
Practice Address - Street 1:7500 212TH ST SW
Practice Address - Street 2:SUITE 212
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7641
Practice Address - Country:US
Practice Address - Phone:425-744-6022
Practice Address - Fax:425-744-0631
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAOP00001058208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE38508Medicare UPIN