Provider Demographics
NPI:1659600443
Name:BELLINGHAM RETINA SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:BELLINGHAM RETINA SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HASSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-656-5892
Mailing Address - Street 1:200 WESTERLY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-6489
Mailing Address - Country:US
Mailing Address - Phone:360-656-5839
Mailing Address - Fax:
Practice Address - Street 1:200 WESTERLY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6489
Practice Address - Country:US
Practice Address - Phone:360-656-5839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00049354174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8512683Medicaid
WA8512683Medicaid