MEDICARE: KIRK BELLON PA-C

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
1	363AM0700X	Medical Physician Assistant	PA10005227	WA

General Provider Information

NPI Number	:	1235134131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRK BELLON PA-C

Provider Business Mailing Address
First Line	:	19379 7TH AVE NE
Second Line	:
City	:	POULSBO
State	:	WA
Zip	:	98370-7504
Country	:	US
Telephone Number	:	360-394-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	19379 7TH AVE NE
Second Line	:
City	:	POULSBO
State	:	WA
Zip	:	98370-7504
Country	:	US
Telephone Number	:	360-394-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	05/24/2021

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Directions to “ KIRK BELLON PA-C” Practice Location

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