1528573870 NPI number — CHRISTOPHER B BESSEY, DDS, PLLC

Table of content: (NPI 1528573870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528573870 NPI number — CHRISTOPHER B BESSEY, DDS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTOPHER B BESSEY, DDS, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528573870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12116 SE MILL PLAIN BLVD STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98684-6000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-256-8200
Provider Business Mailing Address Fax Number:
360-256-9356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12116 SE MILL PLAIN BLVD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98684-6000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-256-8200
Provider Business Practice Location Address Fax Number:
360-256-9356
Provider Enumeration Date:
12/08/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BESSEY
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
BRETT
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
360-949-5171

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , with the licence number:  DE60754754 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1891215034 . This is a "CHRISTOPHER BESSEY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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