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NPI Code Detail

MEDICARE: LISA M VAN HOFWEGEN M.D.

MEDICARE: LISA M VAN HOFWEGEN M.D.
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
1207Q00000XFamily Medicine PhysicianMD60136339WA

General Provider Information

NPI Number : 1568532372
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA M VAN HOFWEGEN M.D.
Provider Business Mailing Address
First Line : 3610 MERIDIAN ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-1732
Country : US
Telephone Number : 360-318-8800
Fax Number :
Provider Business Practice Location Address
First Line : 722 N STATE ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-5334
Country : US
Telephone Number : 360-752-2865
Fax Number : 360-647-8093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 04/27/2026

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