Provider Demographics
NPI:1063695435
Name:BAUGH, JANETTE RAE (LAC)
Entity type:Individual
Prefix:
First Name:JANETTE
Middle Name:RAE
Last Name:BAUGH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 NE 72ND ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5640
Mailing Address - Country:US
Mailing Address - Phone:206-526-1463
Mailing Address - Fax:206-686-7688
Practice Address - Street 1:1003 NE 72ND ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5640
Practice Address - Country:US
Practice Address - Phone:206-526-1463
Practice Address - Fax:206-686-7688
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-08
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000215171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist