Provider Demographics
NPI:1609817238
Name:HARTWELL, LARRY J (MD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:J
Last Name:HARTWELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:1610 GROVER ST
Practice Address - Street 2:SUITE D1
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-1539
Practice Address - Country:US
Practice Address - Phone:360-354-1333
Practice Address - Fax:360-354-5399
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2015-06-15
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Provider Licenses
StateLicense IDTaxonomies
WAMD00027434207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA423898006OtherGROUP HEALTH COOPERATIVE
WA080147957OtherRAILROAD MEDICARE
WA45917OtherREGENCE BLUESHIELD
WA0128915OtherLABOR & INDUSTRIES (REG)
WA8117749Medicaid
WA8925026OtherLABOR & INDUSTRIES (CV0
WA080147957OtherRAILROAD MEDICARE
WA8925026OtherLABOR & INDUSTRIES (CV0