Provider Demographics
NPI:1043384506
Name:WALK IN HEALTH CLINIC
Entity Type:Organization
Organization Name:WALK IN HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:NESS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:360-734-2330
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-0306
Mailing Address - Country:US
Mailing Address - Phone:360-734-2330
Mailing Address - Fax:360-733-3886
Practice Address - Street 1:2940 SQUALICUM PKWY
Practice Address - Street 2:SUITE 205
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1892
Practice Address - Country:US
Practice Address - Phone:360-734-2330
Practice Address - Fax:360-733-3886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7072895Medicaid