Provider Demographics
NPI:1699958272
Name:WHITCHURCH BAKER, KATHRYN DOROTHY (CNNP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DOROTHY
Last Name:WHITCHURCH BAKER
Suffix:
Gender:F
Credentials:CNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:MAILSTOP CSB-240
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-2394
Mailing Address - Fax:206-987-7126
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:MAILSTOP CSB-240
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2394
Practice Address - Fax:206-987-7126
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR53074363LN0000X
WAAP60235008363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal