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General NPI Number Information
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NPI Number | 1205158912
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Entity Type | Individual
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Provider Name | BECCA MAE BELLAMY LAT, ATC, LMT
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Gender | Female
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 1334 N WHITMAN LN STE 100
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-6034
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Country | US
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Telephone | 509-927-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 3607 W KIERNAN AVE
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City | SPOKANE
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State | WA
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Zip | 99205-2141
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Country | US
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Telephone | 509-941-3949
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 60049086
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 60888426
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License Number State | WA
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