BELLEVUE OBGYN LLC (NPI# 1104124247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104124247 |
| Entity Type | Organization |
| Organization Name | BELLEVUE OBGYN LLC |
| Practice Address |
1515 116th Ave Ne 205 Bellevue WA 98004-3811 |
| Mailing Address |
1515 116th Ave Ne Suite 205 Bellevue WA 98004-3811 |
| Practice Telephone | 4256981588 |
| Mailing Telephone | 4256981588 |
| Enumeration Date | 2011-03-13 |
| Last Update Date | 2012-08-10 |
| Authorized Official Name | DR. MARK S FAN (MEMBER) |
| Authorized Official Telephone | 4256981588 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | MD60122545 | WA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | BELLEVUE OBGYN LLC | 3255 112th Ave Se, Bellevue, WA 98004-7563 |
| Street Address |
1515 116TH AVE NE 205 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-3811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033132410 | Jf Rosenwald Dds Ps | Dentist | 1515 116th Ave Ne, Suite 305, Bellevue, WA 98004-3811 | 2006-07-25 |
| 1659775419 | Coho Medical Group, Pllc | Internal Medicine | 1515 116th Ave Ne, Suite 201, Bellevue, WA 98004-3811 | 2014-10-22 |
| 1295073997 | Bellevue Hyperbarics,pllc | Clinic/Center | 1515 116th Ave Ne, Suite 202, Bellevue, WA 98004-3811 | 2013-01-30 |
| 1922319722 | Jessica Ann Jones | Massage Therapist | 1515 116th Ave Ne, Suite 109, Bellevue, WA 98004-3811 | 2010-06-25 |
| 1184944332 | Restorix Medical Group Pllc | Specialist | 1515 116th Ave Ne, Suite 300, Bellevue, WA 98004-3811 | 2010-06-09 |
| 1588897102 | Pinnacle Dermatology | Dermatology | 1515 116th Ave Ne, Ste 307, Bellevue, WA 98004-3811 | 2009-08-30 |
| 1417183682 | Sound Acupuncture & Herbs, LLC | Acupuncturist | 1515 116th Ave Ne, Ste 109, Bellevue, WA 98004-3811 | 2009-06-02 |
| 1033355581 | Bellevue Neuromuscular Dentistry LLC | Dentist | 1515 116th Ave Ne, Suite 303, Bellevue, WA 98004-3811 | 2009-01-05 |
| 1548405418 | Michael Nelson Brown | Pain Medicine | 1515 116th Ave Ne, Suite #202, Bellevue, WA 98004-3811 | 2008-12-08 |
| 1962667865 | Jacob D Perkins | Chiropractor | 1515 116th Ave Ne, Suite 202, Bellevue, WA 98004-3811 | 2008-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831659275 | Mary L Chandler | Obstetrics & Gynecology | 6510 151st Pl Se, Bellevue, WA 98006-5026 | 2019-03-21 |
| 1003184839 | Jill Rosetta Varni | Obstetrics & Gynecology | 9923 Lake Washington Blvd Ne, Bellevue, WA 98004-6068 | 2011-12-07 |
| 1891945010 | Glen P Hung | Obstetrics & Gynecology | 68 Cascade Key, Bellevue, WA 98006-1030 | 2008-09-24 |
| 1164685632 | Mark S Fan | Obstetrics & Gynecology | 1515 116th Ave Ne Ste 205, Bellevue, WA 98004-3811 | 2008-07-05 |
| 1720240567 | Janice Lavoie Dobson | Obstetrics & Gynecology | 3865 112th Ave Ne, Bellevue, WA 98004-7657 | 2008-07-01 |
| 1093731135 | Katharine Barrett Avendano | Obstetrics & Gynecology | 2625 Northup Way, Bellevue, WA 98004-1431 | 2006-07-14 |
| 1245274802 | Bellevue Obstetrics and Gynecology Associates PC | Obstetrics & Gynecology | 11507 S 42nd St, Suite 109, Bellevue, NE 68123-6122 | 2006-06-15 |
| 1811996531 | Ann M Kolwitz | Obstetrics & Gynecology | 1231 116th Ave Ne, Suite 950, Bellevue, WA 98004-3804 | 2005-07-14 |
| 1619379039 | Unified Women's Healthcare of Washington Pllc | Obstetrics & Gynecology | 800 Bellevue Way Ne, Suite 400, Bellevue, WA 98004-4286 | 2014-09-17 |
| 1770901357 | Alyson Diana Guillet | Obstetrics & Gynecology | 1231 116th Ave Ne Ste 950, Bellevue, WA 98004-3832 | 2014-04-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.