Healthcare Provider Details

I. General information

NPI: 1376594093
Provider Name (Legal Business Name): BELLINGHAM FAMILY AND WOMEN'S HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 KEY ST STE 106
BELLINGHAM WA
98225-5232
US

IV. Provider business mailing address

1050 LARRABEE AVE STE 204
BELLINGHAM WA
98225-7367
US

V. Phone/Fax

Practice location:
  • Phone: 360-756-9793
  • Fax: 360-752-9007
Mailing address:
  • Phone: 360-756-9793
  • Fax: 360-752-9007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30001197
License Number StateWA

VIII. Authorized Official

Name: MS. BONNIE LYNN SPRAGUE
Title or Position: PRESIDENT
Credential: ARNP
Phone: 360-756-9793