Provider Demographics
NPI:1245293802
Name:ASTHMA & ALLERGY CENTER OF WHATCOM COUNTY, P.S.
Entity type:Organization
Organization Name:ASTHMA & ALLERGY CENTER OF WHATCOM COUNTY, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-756-2000
Mailing Address - Street 1:PO BOX 5495
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0495
Mailing Address - Country:US
Mailing Address - Phone:360-756-2000
Mailing Address - Fax:360-756-2111
Practice Address - Street 1:2075 BARKLEY BLVD
Practice Address - Street 2:STE 220
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6614
Practice Address - Country:US
Practice Address - Phone:360-756-2000
Practice Address - Fax:360-756-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031780207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1110485Medicaid
WA1110485Medicaid
WAG8852570Medicare PIN