MT BAKER SURGERY CENTER, LLC (NPI# 1205196649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205196649 |
| Entity Type | Organization |
| Organization Name | MT BAKER SURGERY CENTER, LLC |
| Practice Address |
4029 Northwest Ave Suite 301 Bellingham WA 98226-9077 |
| Mailing Address |
8524 W Gage Blvd Ste A1 Box 319 Kennewick WA 99336-8241 |
| Practice Telephone | 3607520518 |
| Mailing Telephone | 5095910070 |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-05-18 |
| Authorized Official Name | DR. MATTHEW R PETERSON (OWNER) |
| Authorized Official Telephone | 3607520518 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
MD00040970 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7144637 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | MT BAKER SURGERY CENTER, LLC | 4029 Northwest Ave #301, Bellingham, WA 98226 |
| Street Address |
4029 NORTHWEST AVE SUITE 301 |
| City | BELLINGHAM |
| State | WA |
| Zip Code | 98226-9077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952399719 | Michael F Obergottsberger | Specialist/Technologist | 4029 Northwest Ave, Suite 302, Bellingham, WA 98226-9077 | 2005-10-06 |
| 1457695116 | Sound Pain Alliance | Clinic/Center | 4029 Northwest Ave, Bellingham, WA 98226 | 2012-11-19 |
| 1326308982 | Sound Pain Alliance | Clinic/Center | 4029 Northwest Ave, Bellingham, WA 98226-9077 | 2012-05-16 |
| 1265748016 | Wendy Lucille Tan | Registered Nurse | 4029 Northwest Ave, Suite 301, Bellingham, WA 98226-9077 | 2010-08-30 |
| 1336323047 | Northwest Radiologists Inc., P.s. | Clinic/Center | 4029 Northwest Ave, Suite 301a, Bellingham, WA 98226-9077 | 2007-12-18 |
| 1740322304 | Excel Physical Therapy Inc. | Clinic/Center | 4029 Northwest Ave, Suite #302, Bellingham, WA 98226-9077 | 2007-02-12 |
| 1831128099 | Lisa G Obergottsberger | Physical Therapist | 4029 Northwest Ave, Suite #302, Bellingham, WA 98226-9077 | 2006-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558901090 | Advancement Northwest, LLC | Community/Behavioral Health | 410 W Bakerview Rd Suite 110, Space 107, Bellingham, WA 98226 | 2020-01-13 |
| 1295374882 | Unity Care Northwest | Community/Behavioral Health | Roosevelt Elementary School Bh Services, 2900 Yew St., Bellingham, WA 98226 | 2019-12-30 |
| 1710454913 | Shane Humason | Pharmacist | 1225 East Sunset Drive, Ste 110, Bellingham, WA 98226 | 2018-10-26 |
| 1508342759 | Lydia Place A Nonprofit Corporation | Counselor | 1430 North Garden Street, Bellingham, WA 98226 | 2018-07-11 |
| 1609384486 | Lindsay Grace Davis | Massage Therapist | 1572 Huntley Rd, Bellingham, WA 98226 | 2018-01-16 |
| 1760900765 | Melissa Peters | Massage Therapist | 823 W Larson Rd, Bellingham, WA 98226 | 2017-08-30 |
| 1245754001 | Amber Michelle Wilson | Physical Therapy Assistant | 4860 Cordata Pkwy, North Cascades Health and Rehab, Bellingham, WA 98226 | 2017-08-02 |
| 1063935310 | Sophie Elizabeth Kangas | Speech-Language Pathologist | 4152 Meridian Street, Suite 105, Pmb 159, Bellingham, WA 98226 | 2017-07-19 |
| 1639607849 | Sharon Lynn Katz-kunde | Physical Therapist | 317 E Mcleod Rd #101, Bellingham, WA 98226 | 2017-06-01 |
| 1376998179 | Hyowon Choi | Podiatrist | 2075 Barkley Blvd Ste 220, Bellingham, WA 98226 | 2016-04-28 |
| Find all providers in zip 98226 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952852873 | Pacific Northwest Urology Specialists, Pllc | Clinic/Center | 3232 Squalicum Pkwy, Bellingham, WA 98225-1932 | 2016-10-14 |
| 1194047092 | Pacific Cataract and Laser Institute Inc PC | Clinic/Center | 4330 Mitchell Way, Bellingham, WA 98226 | 2010-02-18 |
| 1013243393 | Mt Baker Pain Clinic, P.s. | Clinic/Center | 4029 Northwest Ave Ste 303, Bellingham, WA 98226-9077 | 2009-10-21 |
| 1144370784 | Bellingham Ear Nose Throat and Facial Surgery Inc | Clinic/Center | 2940 Squalicum Pkwy Ste 203, Bellingham, WA 98225-1892 | 2007-01-12 |
| 1801989710 | Anthony S Karuza Dpm Ps Inc | Clinic/Center | 3120 Squalicum Pkwy, Bellingham, WA 98225-1934 | 2006-10-02 |
| 1184607061 | Pacific Rim Outpatient Surgery Center, Limited Liability Company | Clinic/Center | 3009 Squalicum Pkwy, Bellingham, WA 98225 | 2005-11-23 |
| 1043690126 | Bellingham Urology Group, Pllc | Clinic/Center | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2015-06-04 |
| 1275938102 | Fourth Corner Neurosurgical Associates Inc Ps | Clinic/Center | 710 Birchwood Ave, Suite 101, Bellingham, WA 98225-1720 | 2014-11-04 |
| 1457695116 | Sound Pain Alliance | Clinic/Center | 4029 Northwest Ave, Bellingham, WA 98226 | 2012-11-19 |
| 1508176991 | Mark W. Sheafor, Dpm, Ps, Inc. | Clinic/Center | 3120 Squalicum Pkwy, Suite 2, Bellingham, WA 98225-1934 | 2010-10-19 |
| Find all providers in BELLINGHAM | ||||
| City | BELLINGHAM |
| Zip Code | 98226 |
Please comment or provide details below to improve the information on MT BAKER SURGERY CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.