Provider Demographics
NPI:1700672987
Name:PHILLIPS, JUDE JAMES
Entity type:Individual
Prefix:
First Name:JUDE
Middle Name:JAMES
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 IRON ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4820
Mailing Address - Country:US
Mailing Address - Phone:360-250-6565
Mailing Address - Fax:
Practice Address - Street 1:851 SE PIONEER WAY STE 201
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-5789
Practice Address - Country:US
Practice Address - Phone:360-333-5684
Practice Address - Fax:360-230-3272
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician