MEDICARE: WESTCOAST COUNSELING AND TREATMENT CENTER

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	251S00000X	Community/Behavioral Health Agency	37 1136 00	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669502944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTCOAST COUNSELING AND TREATMENT CENTER

Provider Business Mailing Address
First Line	:	1200 DUPONT ST
Second Line	:	SUITE 1A
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-3100
Country	:	US
Telephone Number	:	360-647-7577
Fax Number	:	360-617-1424

Provider Business Practice Location Address
First Line	:	1200 DUPONT ST
Second Line	:	SUITE 1A
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-3100
Country	:	US
Telephone Number	:	360-647-7577
Fax Number	:	360-617-1424

Authorized Official
Title or Position	:	CO-OWNER
Name	:	LINDA ANN WALLER
Credential	:	CDP
Telephone Number	:	360-647-7577

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	08/22/2020

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