Provider Demographics
NPI:1821110438
Name:BELLA HEALTH LLC
Entity Type:Organization
Organization Name:BELLA HEALTH LLC
Other - Org Name:HOLISTIC HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-646-8575
Mailing Address - Street 1:12320 SW ALLEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4716
Mailing Address - Country:US
Mailing Address - Phone:503-646-8575
Mailing Address - Fax:503-526-0786
Practice Address - Street 1:12320 SW ALLEN BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4716
Practice Address - Country:US
Practice Address - Phone:503-646-8575
Practice Address - Fax:503-526-0786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4960111N00000X
OR272091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR141372Medicare UPIN