1619972932 NPI number — HELEN ANN JAMES MD INC PS

Table of content: (NPI 1619972932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619972932 NPI number — HELEN ANN JAMES MD INC PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HELEN ANN JAMES MD INC PS
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:
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:
1619972932
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3001 SQUALICUM PKWY
Provider Second Line Business Mailing Address:
STE 5
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98225-1950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-676-0972
Provider Business Mailing Address Fax Number:
360-671-4423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 SQUALICUM PKWY
Provider Second Line Business Practice Location Address:
STE 5
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-1950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-676-0972
Provider Business Practice Location Address Fax Number:
360-671-4423
Provider Enumeration Date:
06/14/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JAMES
Authorized Official First Name:
HELEN
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
360-676-0972

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD00020348 , 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: 1005982 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".