| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 09/01/2009 |
| Last Update Date | 11/30/2012 |
| Medicare PECOS PAC ID | 0042366916 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598858599 PECOS PAC ID: 2062325954 Enrollment ID: I20031106000769 |
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