=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083327191
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BELLEVUE HEALTHCARE II INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2023
-----------------------------------------------------
Last Update Date | 01/04/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1314 NE 102ND ST
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98686-4704
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-450-4705
-----------------------------------------------------
Fax | 503-659-1520
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1314 NE 102ND ST
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98686-4704
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-450-4705
-----------------------------------------------------
Fax | 503-659-1520
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JOEL GALLION
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 425-451-2842
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------