Bellevue Clinic for Behavioral Health

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

MD00045130 Issued in WA

Legal business name

BELLEVUE CLINIC FOR BEHAVIORAL HEALTH

Practice address

2105 112TH Ave NE
Suite 201
Bellevue, WA 98004-2945

Phone

(253) 347-2665

NPI assigned

Mar 31, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Osama Bankesly, MD

Title

President

Phone

(206) 403-8814

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1124481783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE",
            "address_2": "SUITE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE",
            "address_2": "SUITE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042945",
            "telephone_number": "253-347-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVUE CLINIC FOR BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "BANKESLY",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-403-8814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "WA",
            "license": "MD00045130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bellevue Center for Health, PLLC
• Bellevue Chiropractic & Massage
• Bellevue Chiropractic Associates
• Bellevue Chiropractic PS
• Bellevue Clinic and Surgery Center
• Bellevue Community Services
• Bellevue Dentist
• Bellevue Ear, Nose & Throat Clinic, Inc
• Bellevue Eastsied Orthodontic Center
• Bellevue Family Counseling LLC

• Prescribing (Medical) Psychologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Prescribing (Medical) Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.