Provider Demographics
NPI:1902373210
Name:BELLINGHAM BAY CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:BELLINGHAM BAY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEAMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-806-7558
Mailing Address - Street 1:1210 PUGET ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2144
Mailing Address - Country:US
Mailing Address - Phone:503-806-7558
Mailing Address - Fax:
Practice Address - Street 1:1200 LAKEWAY DR STE 3
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-2034
Practice Address - Country:US
Practice Address - Phone:503-806-7558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-25
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty