Provider Demographics
NPI:1215139605
Name:WESTERN WASHINGTON UNIVERSITY
Entity type:Organization
Organization Name:WESTERN WASHINGTON UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUTSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-650-3881
Mailing Address - Street 1:516 HIGH ST
Mailing Address - Street 2:PARKS HALL
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5946
Mailing Address - Country:US
Mailing Address - Phone:360-650-3881
Mailing Address - Fax:
Practice Address - Street 1:516 HIGH ST
Practice Address - Street 2:PARKS HALL
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5946
Practice Address - Country:US
Practice Address - Phone:360-650-3881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00003523261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech