Provider Demographics
NPI:1396704342
Name:BAUMGART, ERIN KATHLEEN (ARNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHLEEN
Last Name:BAUMGART
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-5096
Mailing Address - Country:US
Mailing Address - Phone:360-715-4186
Mailing Address - Fax:360-715-4143
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1989
Practice Address - Country:US
Practice Address - Phone:360-715-4186
Practice Address - Fax:360-715-4143
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003790363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1396704342Medicaid
WA5224BUOtherREGENCE
WA5776745OtherAETNA
WA1396704342Medicaid
WA5224BUOtherREGENCE