Provider Demographics
NPI:1972900751
Name:DEALMEIDA, BRUNO (LMP)
Entity type:Individual
Prefix:
First Name:BRUNO
Middle Name:
Last Name:DEALMEIDA
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 CORNWALL AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5023
Mailing Address - Country:US
Mailing Address - Phone:360-920-3898
Mailing Address - Fax:
Practice Address - Street 1:1229 CORNWALL AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5023
Practice Address - Country:US
Practice Address - Phone:360-920-3898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-22
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022675174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist