Healthcare Provider Details

I. General information

NPI: 1396965844
Provider Name (Legal Business Name): BELLEVUE BONE & JOINT PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1632 116TH AVE NE SUITE C
BELLEVUE WA
98004-3035
US

IV. Provider business mailing address

1632 116TH AVE NE SUITE C
BELLEVUE WA
98004-3035
US

V. Phone/Fax

Practice location:
  • Phone: 425-462-9800
  • Fax: 425-454-9143
Mailing address:
  • Phone: 425-462-9800
  • Fax: 425-454-9143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES E CLARK
Title or Position: PARTNER
Credential: M.D.
Phone: 425-462-9800