Provider Demographics
NPI:1154618510
Name:BELLEVUE HEALTHCARE II INC
Entity type:Organization
Organization Name:BELLEVUE HEALTHCARE II INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-451-2842
Mailing Address - Street 1:2015 152ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5521
Mailing Address - Country:US
Mailing Address - Phone:425-740-5060
Mailing Address - Fax:425-740-5062
Practice Address - Street 1:115 E HARRISON AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-3238
Practice Address - Country:US
Practice Address - Phone:208-676-1768
Practice Address - Fax:208-665-9630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID332B00000X, 332BC3200X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1285853069Medicaid
ID1285853069Medicaid