MEDICARE: COUNTY OF WHATCOM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2400X	Prison Health Clinic/Center

General Provider Information

NPI Number	:	1134011554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF WHATCOM

Provider Business Mailing Address
First Line	:	311 GRAND AVE
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-4048
Country	:	US
Telephone Number	:	360-778-6466
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 GRAND AVE
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-4048
Country	:	US
Telephone Number	:	360-778-6466
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DISBURSEMENT
Name	:	NICOLE KALLIN
Credential	:
Telephone Number	:	360-778-6466

Provider Enumeration Date	:	07/18/2025
Last Update Date	:	07/18/2025

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Directions to “COUNTY OF WHATCOM ” Practice Location

Language	Start Address	Practice Location

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