Provider Demographics
NPI:1871872473
Name:BAUGHER, BOBBIE (RDH)
Entity type:Individual
Prefix:MS
First Name:BOBBIE
Middle Name:
Last Name:BAUGHER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15309 NE 90TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-3597
Mailing Address - Country:US
Mailing Address - Phone:360-513-1115
Mailing Address - Fax:
Practice Address - Street 1:15309 NE 90TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-3597
Practice Address - Country:US
Practice Address - Phone:360-513-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00005616124Q00000X
ORH3586124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist