Provider Demographics
NPI:1154152916
Name:BAXTER, ANTHONY SR
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:BAXTER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5039 31ST AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-3055
Mailing Address - Country:US
Mailing Address - Phone:206-413-0307
Mailing Address - Fax:
Practice Address - Street 1:5039 31ST AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-3055
Practice Address - Country:US
Practice Address - Phone:206-413-0307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor