Provider Demographics
NPI:1285853069
Name:BELLEVUE HEALTHCARE II INC
Entity Type:Organization
Organization Name:BELLEVUE HEALTHCARE II INC
Other - Org Name:BELLEVUE HEALTHCARE INLAND NW II INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LABELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-532-7779
Mailing Address - Street 1:2015 152ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5521
Mailing Address - Country:US
Mailing Address - Phone:425-740-5060
Mailing Address - Fax:425-740-5062
Practice Address - Street 1:45 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3601
Practice Address - Country:US
Practice Address - Phone:509-327-7799
Practice Address - Fax:509-532-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603037535332B00000X, 332BC3200X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6587890002Medicare NSC