Lisa A Jungclas Ph D Inc | |
12 Bellwether Way Ste 220 Bellingham WA 98225-2914 | |
(360) 734-7310 | |
(360) 647-8336 |
Full Name | Lisa A Jungclas Ph D Inc |
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Speciality | Psychologist |
Location | 12 Bellwether Way Ste 220, Bellingham, Washington |
Authorized Official Name and Position | Lori Peters (OFFICE MANAGER) |
Authorized Official Contact | 3607347310 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lisa A Jungclas Ph D Inc 12 Bellwether Way Ste 220 Bellingham WA 98225 Ph: (360) 734-7310 | Lisa A Jungclas Ph D Inc 12 Bellwether Way Ste 220 Bellingham WA 98225-2914 Ph: (360) 734-7310 |
NPI Number | 1508099060 |
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Provider Enumeration Date | 09/01/2009 |
Last Update Date | 11/30/2012 |
Medicare PECOS PAC ID | 0042366916 |
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Medicare Enrollment ID | O20090917000256 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508099060 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | PY00002518 (Washington) | Primary |
Provider Name | Lisa A Jungclas |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1598858599 PECOS PAC ID: 2062325954 Enrollment ID: I20031106000769 |
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