Provider Demographics
NPI:1356483911
Name:BELLINGHAM EYE PHYSICIANS PS
Entity Type:Organization
Organization Name:BELLINGHAM EYE PHYSICIANS PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:KULLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-676-8663
Mailing Address - Street 1:4540 CORDATA PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8059
Mailing Address - Country:US
Mailing Address - Phone:360-676-8663
Mailing Address - Fax:360-676-8682
Practice Address - Street 1:4540 CORDATA PKWY STE 103
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8059
Practice Address - Country:US
Practice Address - Phone:360-676-8663
Practice Address - Fax:360-676-8682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00001938152W00000X
WAMD00012453207W00000X
WAMD00042140207W00000X
WAOP00002031207W00000X
WAMD00035922207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAH51721Medicare UPIN
WAU12354Medicare UPIN
WAG63003Medicare UPIN
WAF88657Medicare UPIN
WAA09426Medicare UPIN