Provider Demographics
NPI:1265573844
Name:GREGORY J. HELGATH, INC. PS
Entity type:Organization
Organization Name:GREGORY J. HELGATH, INC. PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HELGATH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-354-3030
Mailing Address - Street 1:210 THIRD ST.
Mailing Address - Street 2:
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-1411
Mailing Address - Country:US
Mailing Address - Phone:360-354-3030
Mailing Address - Fax:360-354-1013
Practice Address - Street 1:210 THIRD ST.
Practice Address - Street 2:
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-1411
Practice Address - Country:US
Practice Address - Phone:360-354-3030
Practice Address - Fax:360-354-1013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009976174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB09344Medicare PIN