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NPI Code Detail

MEDICARE: JANE BELLOUSOV

MEDICARE: JANE BELLOUSOV
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMASS.MA.70095486WA

General Provider Information

NPI Number : 1205773983
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE BELLOUSOV
Provider Business Mailing Address
First Line : 2717 144TH CT SE
Second Line :
City : MILL CREEK
State : WA
Zip : 98012-5741
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4030 ALDERWOOD MALL BLVD
Second Line :
City : LYNNWOOD
State : WA
Zip : 98036-6763
Country : US
Telephone Number : 425-776-0803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2026
Last Update Date : 05/01/2026

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Directions to “ JANE BELLOUSOV ” Practice Location

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