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Contact Information

FAIRHAVEN DERMATOLOGY, PLLC
3105 OLD FAIRHAVEN PKWY, SUITE 101
BELLINGHAM, WA98225
 Phone: 360-656-6278
 Fax: 360-778-1804
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for FAIRHAVEN DERMATOLOGY PLLC · (Female)

NPI Number 1336693902
Status Active
Credentials
Entity Individual
Enumeration date 08/11/2016
Last updated 04/25/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • WA License # 603616109
  • WA Medicaid 2073078
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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