Basic Information
| Provider Information | |||||||||
| NPI: | 1225302680 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WHATCOM COUNSELING & PSYCHIATRIC CLINIC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | FERNDALE FAMILY MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5580 NORDIC WAY | ||||||||
| Address2: | |||||||||
| City: | FERNDALE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98248 | ||||||||
| CountryCode: | US | ||||||||
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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: | 03/02/2012 | ||||||||
| LastUpdateDate: | 03/02/2012 | ||||||||
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| AuthorizedOfficialLastName: | WIGHT | ||||||||
| AuthorizedOfficialFirstName: | DEAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3606762220 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.