Provider Demographics
NPI:1427271915
Name:BIELLING, JOSEPH E (LMP, NCTMB)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:BIELLING
Suffix:
Gender:M
Credentials:LMP, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4546 CALIFORNIA AVE SW
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4111
Mailing Address - Country:US
Mailing Address - Phone:206-852-1297
Mailing Address - Fax:206-453-5630
Practice Address - Street 1:4546 CALIFORNIA AVE SW
Practice Address - Street 2:SUITE 202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4111
Practice Address - Country:US
Practice Address - Phone:206-852-1297
Practice Address - Fax:206-453-5630
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023212225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0229762OtherL&I
1A580OtherPREMERA SUBMITTER ID
CA406143OtherABMP
WA518637-06OtherNCTMB
WA197047OtherAMTA PROFESSIONAL MEMBER
CAP 632525-955OtherCA MASSAGE PERMIT
CAP 632525-955OtherCA MASSAGE PERMIT