Provider Demographics
NPI:1285195487
Name:BAEK, ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BAEK
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3580 JOSEPH SIEWICK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-1764
Mailing Address - Country:US
Mailing Address - Phone:571-472-6464
Mailing Address - Fax:
Practice Address - Street 1:3580 JOSEPH SIEWICK DR STE 105
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1764
Practice Address - Country:US
Practice Address - Phone:571-472-6464
Practice Address - Fax:703-391-3965
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2025-02-10
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Provider Licenses
StateLicense IDTaxonomies
VA0110006920363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical