Healthcare Provider Details

I. General information

NPI: 1952385130
Provider Name (Legal Business Name): JOSHUA C. COHEN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 11TH STREET SUITE 301
BELLINGHAM WA
98225
US

IV. Provider business mailing address

1112 11TH STREET SUITE 301
BELLINGHAM WA
98225
US

V. Phone/Fax

Practice location:
  • Phone: 360-671-0383
  • Fax: 360-756-8850
Mailing address:
  • Phone: 360-671-0383
  • Fax: 360-756-8850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number203646
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMB08033400
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOP00002259
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: