Provider Demographics
NPI:1265748016
Name:TAN, WENDY LUCILLE (ARNP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LUCILLE
Last Name:TAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 SQUALICUM PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1854
Mailing Address - Country:US
Mailing Address - Phone:360-734-5400
Mailing Address - Fax:
Practice Address - Street 1:4029 NORTHWEST AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9077
Practice Address - Country:US
Practice Address - Phone:360-752-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60176838163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse