Provider Demographics
NPI:1073112637
Name:SIMPSON, CAROLINE SAMANTHA (MSN)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:SAMANTHA
Last Name:SIMPSON
Suffix:
Gender:
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-3311
Mailing Address - Country:US
Mailing Address - Phone:734-476-1520
Mailing Address - Fax:
Practice Address - Street 1:1501 FRASER ST # M-104
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-5828
Practice Address - Country:US
Practice Address - Phone:734-476-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI61102620133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered