Provider Demographics
NPI:1992745699
Name:MCALLISTER, VERMONT H (MD)
Entity type:Individual
Prefix:DR
First Name:VERMONT
Middle Name:H
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:873 HINOTES CT
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-9043
Mailing Address - Country:US
Mailing Address - Phone:360-318-9705
Mailing Address - Fax:360-318-8735
Practice Address - Street 1:3500 ORCHARD PL
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1749
Practice Address - Country:US
Practice Address - Phone:360-671-3900
Practice Address - Fax:360-647-0882
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00011625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA02717OtherREGENCE BLUESHIELD
WA0130080OtherLABOR & INDUSTRIES (REG)
WA1040575Medicaid
WA8925038OtherLABOR & INDUSTRIES (CV)
WA8925038OtherLABOR & INDUSTRIES (CV)
WAA09474Medicare UPIN