Individual
MICHAEL JAMES POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR L CHT
Contact information
Practice address
1611 BROADWAY, BELLINGHAM, WA 98225-3039
(360) 676-4263
(360) 671-3366
Mailing address
PO BOX 1557, BELLINGHAM, WA 98227-1557
(360) 676-4263
(660) 671-3366
Taxonomy
Speciality
Code
Description
License number
State
2251H1200X
Hand Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0156374
LABOR AND INDUSTRIES
WA
01
—
1960076
FIRST HEALTH
—
01
—
5692P0
REGENCE BLUE SHIELD
WA
05
—
7682388
—
WA
01
—
8935446
CRIME VICTIMS LABOR AND I
WA
Enumeration date
11/08/2005
Last updated
09/06/2007
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