Healthcare Provider Details

I. General information

NPI: 1093660854
Provider Name (Legal Business Name): CHPWHATCOM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 GRAND AVE
BELLINGHAM WA
98225-4048
US

IV. Provider business mailing address

311 GRAND AVE
BELLINGHAM WA
98225-4048
US

V. Phone/Fax

Practice location:
  • Phone: 360-778-6530
  • Fax:
Mailing address:
  • Phone: 360-778-6530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: EMILY BLAKE
Title or Position: HEALTH SERVICES ADMINISTRATOR
Credential: RN
Phone: 360-223-7521