Individual
PHILLIPS B TRAUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4164 MERIDIAN ST, SUITE 300, BELLINGHAM, WA 98226-5583
(360) 676-8822
(360) 676-7488
Mailing address
4164 MERIDIAN ST, SUITE 300, BELLINGHAM, WA 98226-5583
(360) 676-8822
(360) 676-7488
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00005494
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0174916
STATE LABOR AND INDUSTRIE
WA
01
—
3872TR
REGENCE BLUE SHIELD
WA
05
—
5044672
—
WA
Enumeration date
10/27/2006
Last updated
10/30/2009
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