Healthcare Provider Details

I. General information

NPI: 1184935090
Provider Name (Legal Business Name): CASEY JAMES LIEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 UNITY ST
BELLINGHAM WA
98225-4429
US

IV. Provider business mailing address

1616 CORNWALL AVE STE 205
BELLINGHAM WA
98225-4648
US

V. Phone/Fax

Practice location:
  • Phone: 360-676-6177
  • Fax: 360-671-3574
Mailing address:
  • Phone: 360-676-6177
  • Fax: 360-671-3574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number60369048
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60369048
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: