Provider Demographics
NPI:1326262452
Name:WESTERN WASHINGTON UNIVERSITY STUDENT HEALTH CENTER
Entity Type:Organization
Organization Name:WESTERN WASHINGTON UNIVERSITY STUDENT HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR STUDENT HEALTH CENTER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-650-7328
Mailing Address - Street 1:516 HIGH ST
Mailing Address - Street 2:MS 9132
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5946
Mailing Address - Country:US
Mailing Address - Phone:360-650-7352
Mailing Address - Fax:360-650-3883
Practice Address - Street 1:516 HIGH ST
Practice Address - Street 2:MS 9132
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5946
Practice Address - Country:US
Practice Address - Phone:360-650-7352
Practice Address - Fax:360-650-3883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health