Basic Information
| Provider Information | |||||||||
| NPI: | 1114054764 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILCHRIST | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | CLINTON | ||||||||
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| Credential: | BA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1493 PILCHUCK DR | ||||||||
| Address2: | |||||||||
| City: | CAMANO ISLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982828200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603872397 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3645 E MCLEOD RD | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982268700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606762220 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 03/10/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | RC00005258 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.