Provider Demographics
NPI:1659702439
Name:BELLUS, AMANDA JOY (RN BSN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JOY
Last Name:BELLUS
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9407 NE 166TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-1592
Mailing Address - Country:US
Mailing Address - Phone:360-949-5658
Mailing Address - Fax:541-647-6554
Practice Address - Street 1:9407 NE 166TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-1592
Practice Address - Country:US
Practice Address - Phone:360-949-5658
Practice Address - Fax:541-647-6554
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201041507RN163W00000X, 163WC1500X
WARN60342667163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health