NPIMap

Organization Active NPI

Mt Baker Pain Clinic, P.S.

  • Ambulatory Surgical Clinic/Center
  • Bellingham, WA
National Provider Identifier
1013243393
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
602939596 Issued in WA
Legal business name
MT BAKER PAIN CLINIC, P.S.
Practice address
4029 Northwest Ave Ste 303
Bellingham, WA 98226-9077
Phone
(360) 752-0518
Fax
(360) 676-2896
NPI assigned
Oct 21, 2009
Last updated
Oct 21, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
MT BAKER PAIN CLINIC, P.S.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Cerar, RN, CRRN, CASC
Title
Clinical Manager
Phone
(360) 752-0518

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 602939596 WA Primary

Addresses

Primary practice location

4029 Northwest Ave Ste 303
Bellingham, WA 98226-9077

Mailing address

4029 Northwest Ave Ste 301
Bellingham, WA 98226-9077
Phone (360) 752-0518

National Provider Directory

National Provider Directory
Tax ID family
Mt Baker Pain Clinic PS3 organizations share this tax ID, including this one
Part of
Mt Baker Pain Clinic PS

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256083200000",
    "number": "1013243393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 NORTHWEST AVE STE 301",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269077",
            "telephone_number": "360-752-0518",
            "fax_number": "360-676-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 NORTHWEST AVE STE 303",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269077",
            "telephone_number": "360-752-0518",
            "fax_number": "360-676-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT BAKER PAIN CLINIC, P.S.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MT BAKER PAIN CLINIC, P.S.",
        "enumeration_date": "2009-10-21",
        "last_updated": "2009-10-21",
        "status": "A",
        "authorized_official_last_name": "CERAR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "360-752-0518",
        "authorized_official_credential": "RN, CRRN, CASC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "602939596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.