MEDICARE: DR. LARRY J. HARTWELL MD

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	207Q00000X	Family Medicine Physician	MD00027434	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080147957	OTHER	WA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	423898006	OTHER	WA	GROUP HEALTH COOPERATIVE
3	45917	OTHER	WA	REGENCE BLUESHIELD
4	0128915	OTHER	WA	LABOR & INDUSTRIES (REG)
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	8925026	OTHER	WA	LABOR & INDUSTRIES (CV0

General Provider Information

NPI Number	:	1609817238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY J. HARTWELL MD

Provider Business Mailing Address
First Line	:	709 W ORCHARD DR
Second Line	:	SUITE 4
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-1766
Country	:	US
Telephone Number	:	360-318-8800
Fax Number	:	360-318-1085

Provider Business Practice Location Address
First Line	:	1610 GROVER ST
Second Line	:	SUITE D1
City	:	LYNDEN
State	:	WA
Zip	:	98264-1539
Country	:	US
Telephone Number	:	360-354-1333
Fax Number	:	360-354-5399

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	06/15/2015

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Directions to “ DR. LARRY J. HARTWELL MD” Practice Location

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