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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

NPI Number 1336693902
LBN Legal business name FAIRHAVEN DERMATOLOGY, PLLC
Authorized official THOMAS LANGEI - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/11/2016
Last updated 04/25/2019 - About 7 years ago
Identifiers
WA License # 603616109
WA Medicaid 2073078
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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