Healthcare Provider Details

I. General information

NPI: 1154665842
Provider Name (Legal Business Name): LOWELL TERRY BELL M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2012
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7507 NE 51ST ST
VANCOUVER WA
98662-6007
US

IV. Provider business mailing address

8501 NE 59TH CIRCLE
VANCOUVER WA
98662
US

V. Phone/Fax

Practice location:
  • Phone: 360-906-1190
  • Fax:
Mailing address:
  • Phone: 360-882-4704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberLH00006920
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: