Healthcare Provider Details

I. General information

NPI: 1326262452
Provider Name (Legal Business Name): WESTERN WASHINGTON UNIVERSITY STUDENT HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 HIGH ST MS 9132
BELLINGHAM WA
98225-5946
US

IV. Provider business mailing address

516 HIGH ST MS 9132
BELLINGHAM WA
98225-5946
US

V. Phone/Fax

Practice location:
  • Phone: 360-650-3400
  • Fax: 360-650-3883
Mailing address:
  • Phone: 360-650-3400
  • Fax: 360-650-3883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: CHRISTINE HANCOCK
Title or Position: DIRECTOR
Credential: MD
Phone: 360-650-2237