Provider Demographics
NPI:1396361820
Name:SPENCER, JOHN DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:SPENCER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JACK
Other - Middle Name:
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2940 SQUALICUM PKWY STE 203
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1892
Mailing Address - Country:US
Mailing Address - Phone:360-733-0640
Mailing Address - Fax:
Practice Address - Street 1:2940 SQUALICUM PKWY STE 203
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1892
Practice Address - Country:US
Practice Address - Phone:360-733-0640
Practice Address - Fax:360-733-1034
Is Sole Proprietor?:No
Enumeration Date:2020-06-20
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8893207Y00000X
WAMD.MD.70024756207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology