Provider Demographics
NPI:1982181723
Name:BAIRD, JESSICA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BAIRD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 E 10TH AVE LOT 20
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-6412
Mailing Address - Country:US
Mailing Address - Phone:509-308-2443
Mailing Address - Fax:
Practice Address - Street 1:512 N YOUNG ST STE C
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7839
Practice Address - Country:US
Practice Address - Phone:509-735-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2025-03-19
Deactivation Date:2022-10-12
Deactivation Code:
Reactivation Date:2025-03-18
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist