1790940773 NPI number — BELLEVUE HEALTHCARE II INC

Table of content: (NPI 1790940773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790940773 NPI number — BELLEVUE HEALTHCARE II INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELLEVUE HEALTHCARE II INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BELLEVUE HEALTHCARE WHATCOM COUNTY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790940773
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2015 152ND AVE NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REDMOND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98052-5521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-740-5060
Provider Business Mailing Address Fax Number:
425-740-5062

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1025 N STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-5011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-527-0475
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GALLION
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
425-451-2842

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  6022623725 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X , with the licence number: 603037535 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 603037535 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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