Provider Demographics
NPI:1043774953
Name:BELLMAN, MARYANNE PHILLIPS (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARYANNE
Middle Name:PHILLIPS
Last Name:BELLMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MARYANNE
Other - Middle Name:
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:P.O. BOX 401
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370
Mailing Address - Country:US
Mailing Address - Phone:302-293-2119
Mailing Address - Fax:
Practice Address - Street 1:442 VIEWMONT AVE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370
Practice Address - Country:US
Practice Address - Phone:302-293-2119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60549591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist