Healthcare Provider Details

I. General information

NPI: 1245720861
Provider Name (Legal Business Name): FOX AND THISTLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 W HOLLY ST STE 320
BELLINGHAM WA
98225-4329
US

IV. Provider business mailing address

19091 COOK RD
BURLINGTON WA
98233-9698
US

V. Phone/Fax

Practice location:
  • Phone: 360-421-2741
  • Fax:
Mailing address:
  • Phone: 360-421-2741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JANET E EDWARDS
Title or Position: PROVIDER
Credential: LICSW
Phone: 360-421-2741