Provider Demographics
NPI:1811464654
Name:BELL, REBECCA (DC, MS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 NE FOUR SEASONS LN APT G338
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-4323
Mailing Address - Country:US
Mailing Address - Phone:360-904-7096
Mailing Address - Fax:
Practice Address - Street 1:5331 SW MACADAM AVE STE 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3848
Practice Address - Country:US
Practice Address - Phone:503-445-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60895789111N00000X
OR5940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor