Provider Demographics
NPI:1962470393
Name:HALE, NORMAN O (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:O
Last Name:HALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4058
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-4058
Mailing Address - Country:US
Mailing Address - Phone:360-738-2126
Mailing Address - Fax:
Practice Address - Street 1:1110 LARRABEE AVE STE 202
Practice Address - Street 2:SUITE 202
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7302
Practice Address - Country:US
Practice Address - Phone:360-734-3993
Practice Address - Fax:360-734-3633
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000316462084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1094044Medicaid
WA1094044Medicaid
WA8854125Medicare ID - Type Unspecified