Provider Demographics
NPI:1023016102
Name:BELLINGHAM PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:BELLINGHAM PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BOOKKEEPER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-647-0444
Mailing Address - Street 1:306 36TH ST
Mailing Address - Street 2:SEHOME VILLAGE
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6580
Mailing Address - Country:US
Mailing Address - Phone:360-647-0444
Mailing Address - Fax:360-650-1497
Practice Address - Street 1:306 36TH ST
Practice Address - Street 2:SEHOME VILLAGE
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6580
Practice Address - Country:US
Practice Address - Phone:360-647-0444
Practice Address - Fax:360-650-1497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7073836Medicaid
WA0105000OtherLABOR AND INDUSTRIES
WA0105000OtherLABOR AND INDUSTRIES