Provider Demographics
NPI:1477979128
Name:MCNABB, BELIA E
Entity type:Individual
Prefix:MRS
First Name:BELIA
Middle Name:E
Last Name:MCNABB
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BELIA
Other - Middle Name:E
Other - Last Name:MCNABB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3370 N. HAYDEN ROAD
Mailing Address - Street 2:PO BOX 123-505
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251
Mailing Address - Country:US
Mailing Address - Phone:832-377-5968
Mailing Address - Fax:
Practice Address - Street 1:852 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2406
Practice Address - Country:US
Practice Address - Phone:360-501-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1233539225100000X
WA60543489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2072990Medicaid