Healthcare Provider Details

I. General information

NPI: 1356483911
Provider Name (Legal Business Name): BELLINGHAM EYE PHYSICIANS PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 CORDATA PKWY STE 103
BELLINGHAM WA
98226-8059
US

IV. Provider business mailing address

4540 CORDATA PKWY STE 103
BELLINGHAM WA
98226-8059
US

V. Phone/Fax

Practice location:
  • Phone: 360-676-8663
  • Fax: 360-676-8682
Mailing address:
  • Phone: 360-676-8663
  • Fax: 360-676-8682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD00001938
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD00012453
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD00042140
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberOP00002031
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD00035922
License Number StateWA

VIII. Authorized Official

Name: DR. CHRISTOPHER D KULLAS
Title or Position: OWNER
Credential: MD
Phone: 360-676-8663