Provider Demographics
NPI:1619069077
Name:LOHSE, JAMES RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:LOHSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 SQUALICUM PKWY
Mailing Address - Street 2:SUITE #250
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1945
Mailing Address - Country:US
Mailing Address - Phone:360-676-1229
Mailing Address - Fax:
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:SUITE #250
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-676-1229
Practice Address - Fax:360-676-0547
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019525174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA99226OtherLABOR AND INDUSTRIES
WA294950001OtherGROUP HEALTH
WA1076009Medicaid
WA294950001OtherGROUP HEALTH
WAAO9471Medicare UPIN