Healthcare Provider Details

I. General information

NPI: 1851486195
Provider Name (Legal Business Name): ANESIS BEL-RED ASC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 116TH AVE NE SUITE 110
BELLEVUE WA
98004-3809
US

IV. Provider business mailing address

1260 116TH AVE NE STE 110
BELLEVUE WA
98004-3800
US

V. Phone/Fax

Practice location:
  • Phone: 425-455-7225
  • Fax: 425-455-0045
Mailing address:
  • Phone: 425-455-7225
  • Fax: 425-455-0045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: MR. KEVIN MOON
Title or Position: DIRECTOR OF REVENUE AND FINANCE
Credential:
Phone: 206-538-6300