Provider Demographics
NPI:1023194610
Name:MT. BAKER IMAGING LLC
Entity type:Organization
Organization Name:MT. BAKER IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHEDULER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-647-2429
Mailing Address - Street 1:801 W ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1763
Mailing Address - Country:US
Mailing Address - Phone:360-647-2429
Mailing Address - Fax:360-733-0438
Practice Address - Street 1:801 W ORCHARD DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1763
Practice Address - Country:US
Practice Address - Phone:360-647-2429
Practice Address - Fax:360-733-0438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory