MEDICARE: AINE FITZGERALD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SC61471285	WA

General Provider Information

NPI Number	:	1306383526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AINE FITZGERALD

Provider Business Mailing Address
First Line	:	424 W. BAKERVIEW RD
Second Line	:	STE 105 #2020
City	:	BELLINGHAM
State	:	WA
Zip	:	98226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	424 W. BAKERVIEW RD
Second Line	:	STE 105 #2020
City	:	BELLINGHAM
State	:	WA
Zip	:	98226
Country	:	US
Telephone Number	:	415-316-8753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2017
Last Update Date	:	11/25/2024

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