Van Brocklin, Michael D
Van Brocklin, Michael D is an individual health care provider with primary practice located at 4330 Mitchell Way , Bellingham WA 98226-9175. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Van Brocklin, Michael D can be contacted via phone (360) 738-6860.Contact Information
Primary practice address
4330 Mitchell Way
Bellingham WA 98226-9175
Phone: (360) 738-6860
Fax: (360) 738-6853
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD00001307 | Washington |
Profile Details
| NPI number | 1417992900 |
|---|---|
| LBN Legal business name | Van Brocklin, Michael D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 18th, 2006 |
| Last updated | Nov 19th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417992900 | NPPES |
| Alaska | MEDICAID | 1023190 | |
| Alaska | MEDICAID | 2027076 | |
| Alaska | Other | 00939832 | |
| Alaska | MEDICAID | 1010014 | |
| Alaska | Other | 410017358 |
Popular Providers
-
Aginsky, Mark Doron
2520 James Street , Bellingham WA 98225-3830 -
Musselman, Wayne R
720 Birchwood Ave , Bellingham WA 98225-1714 -
Larsen, Kelly Kristine
720 Birchwood Ave , Bellingham WA 98225-1714 -
Larson, Jeffrey A
720 Birchwood Ave , Bellingham WA 98225-1714 -
Young, Spencer M
3080 Northwest Ave , Bellingham WA 98225-1607 -
Pan, Lydia
4299 Meridian St , Bellingham WA 98226-6475 -
Dietz, Gary L.
1303 Cornwall Ave , Bellingham WA 98225-4716 -
Bearden, Brad D
2222 James St Suite, A, Bellingham WA 98225-4152