Provider Demographics
NPI:1225899297
Name:PEACE ARCH VASCULAR PLLC
Entity Type:Organization
Organization Name:PEACE ARCH VASCULAR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-594-4002
Mailing Address - Street 1:1344 KING ST STE 104
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-6215
Mailing Address - Country:US
Mailing Address - Phone:360-594-4002
Mailing Address - Fax:360-594-4006
Practice Address - Street 1:1344 KING ST STE 104
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6215
Practice Address - Country:US
Practice Address - Phone:360-594-4002
Practice Address - Fax:360-594-4006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty