Provider Demographics
NPI:1588658918
Name:BELLANCA, HELEN KATHERINE (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:KATHERINE
Last Name:BELLANCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 SE 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-3101
Mailing Address - Country:US
Mailing Address - Phone:503-235-3575
Mailing Address - Fax:
Practice Address - Street 1:849 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1956
Practice Address - Country:US
Practice Address - Phone:541-386-6380
Practice Address - Fax:541-386-1078
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR132045Medicaid
H03051Medicare UPIN
OR132045Medicaid