Provider Demographics
NPI:1447413653
Name:BEL-RED SLEEP DIAGNOSTIC CENTER LLC
Entity Type:Organization
Organization Name:BEL-RED SLEEP DIAGNOSTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ILAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:425-451-8417
Mailing Address - Street 1:PO BOX 6579
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-0579
Mailing Address - Country:US
Mailing Address - Phone:425-451-8417
Mailing Address - Fax:
Practice Address - Street 1:1414 116TH AVE NE
Practice Address - Street 2:SUITE F
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3801
Practice Address - Country:US
Practice Address - Phone:425-451-8417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB39314Medicare PIN
WAG8884320Medicare PIN