Individual provider Active NPI

Deborah Ann Oksenberg, MD

  • Family Medicine Physician
  • Bellingham, WA
National Provider Identifier
1649323940
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00045175 Issued in WA
Practice address
4455 Cordata Pkwy
Bellingham, WA 98226-8037
Phone
(360) 671-3225
Fax
(360) 671-0000
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00045175 WA Primary

Addresses

Primary practice location

4455 Cordata Pkwy
Bellingham, WA 98226-8037

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-0112

Other identifiers 1

IdentifierTypeStateIssuer
8426868MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051006000094 WA Practitioner - Family Practice 5193796993 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00045175WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Jun 8, 2005 Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Jun 8, 2005 Accepting new patients
Western Washington University Student Health Center Past Accepting new patients

Locations

4455 Cordata Pkwy
Bellingham, WA 98226
Phone (360) 671-3225

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649323940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-0112",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268037",
            "telephone_number": "360-671-3225",
            "fax_number": "360-671-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKSENBERG",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00045175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8426868",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.