Provider Demographics
NPI:1588313639
Name:BELLINGHAM ACUPUNCTURE AND WELLNESS
Entity type:Organization
Organization Name:BELLINGHAM ACUPUNCTURE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AEMP/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-756-5866
Mailing Address - Street 1:2801 MERIDIAN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2400
Mailing Address - Country:US
Mailing Address - Phone:360-756-5866
Mailing Address - Fax:360-734-0843
Practice Address - Street 1:2801 MERIDIAN ST STE 102
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2400
Practice Address - Country:US
Practice Address - Phone:360-756-5866
Practice Address - Fax:360-734-0843
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHANGS CHINESE MEDICINE WELLNESS CENTER, P.S.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1780896399Medicaid