Provider Demographics
NPI:1205487576
Name:BELLEVUE HEALTH CLINIC, LLC
Entity type:Organization
Organization Name:BELLEVUE HEALTH CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GOVERNOR
Authorized Official - Prefix:
Authorized Official - First Name:JIHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:JIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-298-7771
Mailing Address - Street 1:9240 SE SHORELAND DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6519
Mailing Address - Country:US
Mailing Address - Phone:425-298-7771
Mailing Address - Fax:
Practice Address - Street 1:1417 116TH AVE NE STE 204
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3830
Practice Address - Country:US
Practice Address - Phone:425-298-7771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty