Healthcare Provider Details

I. General information

NPI: 1114926532
Provider Name (Legal Business Name): NANCY K BISCHOFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 01/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 CORDATA PKWY
BELLINGHAM WA
98226-7123
US

IV. Provider business mailing address

PO BOX 5096 ATTN: BILLING
BELLINGHAM WA
98227-5096
US

V. Phone/Fax

Practice location:
  • Phone: 360-738-2200
  • Fax:
Mailing address:
  • Phone: 360-752-5608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00035400
License Number StateWA

VII. Legacy identifiers

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

# 1
Identifier8211740
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer
# 2
Identifier0230133
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerL&I

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: