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General NPI Number Information
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NPI Number | 1447548003
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Entity Type | Organization
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Legal Business Name | BELLEVUE WOMEN'S CLINIC PLLC
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 07/18/2011
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Provider Practice Location Address
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Address Line | 22500 SE 64TH PL SUITE 120
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City | ISSAQUAH
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State | WA
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Zip | 98027-8111
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Country | US
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Telephone | 425-998-3474
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Fax |
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Provider Business Mailing Address
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Address Line | 7904 110TH AVE SE APT 207
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City | NEWCASTLE
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State | WA
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Zip | 98056-1684
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Country | US
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Telephone | 425-998-3474
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MABEL K OBENG
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Credential | M.D
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Telephone | 425-417-2968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 60141544
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License Number State | WA
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