Healthcare Provider Details

I. General information

NPI: 1477417483
Provider Name (Legal Business Name): EMMA WINNINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BROADWAY
BELLINGHAM WA
98225-3036
US

IV. Provider business mailing address

1400 BROADWAY
BELLINGHAM WA
98225-3036
US

V. Phone/Fax

Practice location:
  • Phone: 360-922-6977
  • Fax:
Mailing address:
  • Phone: 360-922-6977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: