Provider Demographics
NPI:1558836163
Name:BELL, MICHAEL ORLAND (LMT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ORLAND
Last Name:BELL
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 SE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3735
Mailing Address - Country:US
Mailing Address - Phone:360-675-3034
Mailing Address - Fax:
Practice Address - Street 1:230 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3735
Practice Address - Country:US
Practice Address - Phone:360-675-3034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60877407225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA60877407OtherMASSAGE THERAPIST