Provider Demographics
NPI:1740515410
Name:BELLEVUE HEALTHCARE II, INC
Entity type:Organization
Organization Name:BELLEVUE HEALTHCARE II, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:GALLION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-681-0111
Mailing Address - Street 1:2015 152ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5521
Mailing Address - Country:US
Mailing Address - Phone:425-740-5060
Mailing Address - Fax:425-740-5062
Practice Address - Street 1:520 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3491
Practice Address - Country:US
Practice Address - Phone:360-681-0111
Practice Address - Fax:360-681-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602262372332B00000X
WA603037535332BC3200X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2016258Medicaid
WA6587890008Medicare NSC