Healthcare Provider Details

I. General information

NPI: 1215139605
Provider Name (Legal Business Name): WESTERN WASHINGTON UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 HIGH ST PARKS HALL
BELLINGHAM WA
98225-5946
US

IV. Provider business mailing address

516 HIGH ST PARKS HALL
BELLINGHAM WA
98225-5946
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License NumberLD00003523
License Number StateWA

VIII. Authorized Official

Name: CHRISTINE YOUTSEY
Title or Position: ADMINSTRATIVE ASSISTANT
Credential:
Phone: 360-650-3881