Provider Demographics
NPI:1942579875
Name:BELLEVUE HEALTHCARE LLC
Entity Type:Organization
Organization Name:BELLEVUE HEALTHCARE LLC
Other - Org Name:BELLEVUE HEALTHCARE LLC CENTRAL WASHINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-258-6700
Mailing Address - Street 1:3012 GS CENTER RD
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-9116
Mailing Address - Country:US
Mailing Address - Phone:509-662-8700
Mailing Address - Fax:509-662-8715
Practice Address - Street 1:3012 GS CENTER RD
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-9116
Practice Address - Country:US
Practice Address - Phone:509-662-8700
Practice Address - Fax:509-662-8715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4788590006Medicare NSC