Healthcare Provider Details

I. General information

NPI: 1154618510
Provider Name (Legal Business Name): BELLEVUE HEALTHCARE II INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E HARRISON AVE
COEUR D ALENE ID
83814-3238
US

IV. Provider business mailing address

2015 152ND AVE NE
REDMOND WA
98052-5521
US

V. Phone/Fax

Practice location:
  • Phone: 208-676-1768
  • Fax: 208-665-9630
Mailing address:
  • Phone: 425-740-5060
  • Fax: 425-740-5062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateID

VIII. Authorized Official

Name: JOEL GALLION
Title or Position: PRESIDENT
Credential:
Phone: 425-451-2842