Provider Demographics
NPI:1023216082
Name:BELL, MICHAEL DUNCAN (PT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DUNCAN
Last Name:BELL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19122 SUN CT
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8719
Mailing Address - Country:US
Mailing Address - Phone:916-275-8776
Mailing Address - Fax:
Practice Address - Street 1:140 S MARION AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-3639
Practice Address - Country:US
Practice Address - Phone:260-478-6246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4111589Medicaid
WA4111589Medicaid
WA505240Medicare Oscar/Certification