Healthcare Provider Details

I. General information

NPI: 1427404243
Provider Name (Legal Business Name): ANTHONY BELLSMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANTHONY BELL

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8935 SE POWELL BLVD
PORTLAND OR
97266-1938
US

IV. Provider business mailing address

3530 SE 88TH AVE
PORTLAND OR
97266-2396
US

V. Phone/Fax

Practice location:
  • Phone: 503-772-4335
  • Fax: 509-772-4337
Mailing address:
  • Phone: 503-772-4335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD194011
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: