1841290947 NPI number — CARY S KAUFMAN MD

Table of content: CARY S KAUFMAN MD (NPI 1841290947)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841290947 NPI number — CARY S KAUFMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAUFMAN
Provider First Name:
CARY
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1841290947
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2075 BARKLEY BLVD STE 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98226-6614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-671-9877
Provider Business Mailing Address Fax Number:
360-733-2882

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2075 BARKLEY BLVD STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98226-6614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-671-9877
Provider Business Practice Location Address Fax Number:
360-733-2882
Provider Enumeration Date:
07/29/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MD00014269 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086X0206X , with the licence number: MD00014269 , 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: 50394 . This is a "DEPT OF LABOR INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8923151 . This is a "CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1087766 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".