Healthcare Provider Details

I. General information

NPI: 1891233250
Provider Name (Legal Business Name): TERESA D. BELL, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2522 N PROCTOR ST # 42
TACOMA WA
98406-5338
US

IV. Provider business mailing address

2522 N PROCTOR ST # 42
TACOMA WA
98406-5338
US

V. Phone/Fax

Practice location:
  • Phone: 253-759-5236
  • Fax:
Mailing address:
  • Phone: 253-759-5236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMD 000 38548
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberMD 000 38548
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD 000 38548
License Number StateWA

VIII. Authorized Official

Name: MS. TERESA D BELL
Title or Position: OWNER
Credential: MD
Phone: 253-759-5236