Provider Demographics
NPI:1245221027
Name:HALL, DEBORAH A (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:HALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:A
Other - Last Name:BRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:709 W ORCHARD DRIVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-0066
Mailing Address - Country:US
Mailing Address - Phone:360-318-9705
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:3500 ORCHARD PL
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1749
Practice Address - Country:US
Practice Address - Phone:360-671-3900
Practice Address - Fax:360-647-0882
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR39909207Q00000X
WAMD00047288207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5567HAOtherREGENCE BLUESHIELD
WA8468498Medicaid
WA8943035OtherL AND I CRIME VICTIM
WAP00411384OtherRR MEDICARE
WA0214988OtherL AND I REGULAR
WA192942503OtherL AND I FEDERAL USDOL
CO54183855Medicaid
WAP00411384OtherRR MEDICARE
WA8468498Medicaid
WAG84625Medicare UPIN