Provider Demographics
NPI:1154200228
Name:BAKER, BETSY R
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:R
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:R
Other - Last Name:HARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4207 BURNHAM DR
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-1061
Mailing Address - Country:US
Mailing Address - Phone:253-861-5336
Mailing Address - Fax:
Practice Address - Street 1:4207 BURNHAM DR
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-1061
Practice Address - Country:US
Practice Address - Phone:253-861-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health