Basic Information
| Provider Information | |||||||||
| NPI: | 1710435748 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | KARI | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA, NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4100 SW POMONA ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972197442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032446051 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 18765 SW BOONES FERRY RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | TUALATIN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970628496 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036121000 | ||||||||
| FaxNumber: | 5036121090 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2016 | ||||||||
| LastUpdateDate: | 09/19/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | OR | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.