Provider Demographics
NPI:1487625331
Name:BAKER, RAY M JR (MD)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:M
Last Name:BAKER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 34036
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1036
Mailing Address - Country:US
Mailing Address - Phone:425-899-3292
Mailing Address - Fax:425-899-3269
Practice Address - Street 1:11800 NE 128TH ST
Practice Address - Street 2:SUITE 530
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7208
Practice Address - Country:US
Practice Address - Phone:425-454-1111
Practice Address - Fax:425-454-7653
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00026153207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA100925OtherL&I #
WA7087521Medicaid
WA100925OtherL&I #
WAAB22943Medicare ID - Type Unspecified
WAE17360Medicare UPIN