Provider Demographics
NPI:1922891597
Name:BLOOM WOMENS HEALTHCARE PLLC
Entity type:Organization
Organization Name:BLOOM WOMENS HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:READ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-605-3662
Mailing Address - Street 1:143 W KELLOGG RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8009
Mailing Address - Country:US
Mailing Address - Phone:564-565-0338
Mailing Address - Fax:800-420-8703
Practice Address - Street 1:143 W KELLOGG RD STE 2
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8009
Practice Address - Country:US
Practice Address - Phone:564-565-0338
Practice Address - Fax:800-420-8703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty