Healthcare Provider Details

I. General information

NPI: 1154706190
Provider Name (Legal Business Name): WILLIAM BRENTON ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2979 SQUALICUM PKWY STE 101
BELLINGHAM WA
98225
US

IV. Provider business mailing address

2979 SQUALICUM PKWY STE 101
BELLINGHAM WA
98225-1813
US

V. Phone/Fax

Practice location:
  • Phone: 360-734-2700
  • Fax: 360-734-8362
Mailing address:
  • Phone: 360-734-2700
  • Fax: 360-734-8362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60582496
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: