MEDICARE: RUSSELL H SHEINKOPF MD

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	2084P0800X	Psychiatry Physician	MD00030177	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831286467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSSELL H SHEINKOPF MD

Provider Business Mailing Address
First Line	:	119 N COMMERCIAL ST
Second Line	:	SUITE 290
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-4446
Country	:	US
Telephone Number	:	360-647-1687
Fax Number	:	360-366-7234

Provider Business Practice Location Address
First Line	:	119 N COMMERCIAL ST
Second Line	:	SUITE 290
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-4446
Country	:	US
Telephone Number	:	360-647-1687
Fax Number	:	360-366-7234

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	12/28/2009

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