Healthcare Provider Details

I. General information

NPI: 1912078486
Provider Name (Legal Business Name): WESTERN WASHINGTON UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 HIGH ST MAIL STOP 9078
BELLINGHAM WA
98225-5946
US

IV. Provider business mailing address

516 HIGH ST MAIL STOP 9078
BELLINGHAM WA
98225-5946
US

V. Phone/Fax

Practice location:
  • Phone: 360-650-3881
  • Fax: 360-650-4334
Mailing address:
  • Phone: 360-650-3881
  • Fax: 360-650-4334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateWA

VIII. Authorized Official

Name: MS. CHRISTINE ANNE YOUTSEY
Title or Position: OFFICE ASSISTANT III
Credential: BA
Phone: 360-650-3881