Provider Demographics
NPI:1982703732
Name:BELL, GREGORY H (PA)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:H
Last Name:BELL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 58009
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-1009
Mailing Address - Country:US
Mailing Address - Phone:425-235-4181
Mailing Address - Fax:425-277-3785
Practice Address - Street 1:30308 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-2546
Practice Address - Country:US
Practice Address - Phone:253-332-1011
Practice Address - Fax:253-351-9907
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10002234363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical