Fairhaven Medical Center

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

FAIRHAVEN MEDICAL CENTER

Practice address

1401 6TH St
Bellingham, WA 98225-7057

Phone

(360) 733-2904

Fax

(833) 464-3389

NPI assigned

Jan 3, 2023

Organization subpart

No

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

Authorized official

Name

Mackenzie Sproule, ARNP

Title

Owner

Phone

(360) 899-4086

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1265145403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 6TH ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257057",
            "telephone_number": "360-733-2904",
            "fax_number": "833-464-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 6TH ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257057",
            "telephone_number": "360-733-2904",
            "fax_number": "833-464-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRHAVEN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-14",
        "status": "A",
        "authorized_official_last_name": "SPROULE",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-899-4086",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus A Fairbanks, DDS
• Fairhaven Behavioral Health & Wellness PC
• Fairhaven Dermatology, PLLC
• Fairhaven Integrative Health, PLLC
• Fairhaven Lactation, LLC
• Fairhaven Vision Clinic PLLC
• Faith Alliance LLC
• Emily Falls, BCBA, LBA, MED
• Family Care Network PLLC
• Family Care Network PLLC

• All providers in Bellingham, WA
• Health Service Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.