Healthcare Provider Details

I. General information

NPI: 1245741040
Provider Name (Legal Business Name): JUSTINE NICOLE GRIFFITH BARROETA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 MERIDIAN ST
BELLINGHAM WA
98225-1732
US

IV. Provider business mailing address

3600 MERIDIAN ST
BELLINGHAM WA
98225-1732
US

V. Phone/Fax

Practice location:
  • Phone: 360-676-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number2771
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: