Provider Demographics
NPI:1881883775
Name:BELLINGHAM FAMILY MEDICINE, PLLC
Entity type:Organization
Organization Name:BELLINGHAM FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:NUETZMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:360-738-7988
Mailing Address - Street 1:PO BOX 2536
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-2536
Mailing Address - Country:US
Mailing Address - Phone:360-738-7988
Mailing Address - Fax:360-738-4072
Practice Address - Street 1:12 BELLWETHER WAY
Practice Address - Street 2:#222
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-738-7988
Practice Address - Fax:360-738-4072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1124320Medicaid