Healthcare Provider Details

I. General information

NPI: 1174036826
Provider Name (Legal Business Name): BELLEVUE ORTHOPEDIC PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 112TH AVE NE STE C210
BELLEVUE WA
98004
US

IV. Provider business mailing address

7683 SE 27TH ST # 254
MERCER ISLAND WA
98040-2804
US

V. Phone/Fax

Practice location:
  • Phone: 425-999-3580
  • Fax: 425-999-3122
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SARA JENSEN TRUMBLE
Title or Position: PRACTICE MANAGER
Credential: SPHR
Phone: 425-999-3580