Organization Active NPI

Bellevue Medical Clinic LLC

  • Internal Medicine Physician
  • Lakewood, WA
National Provider Identifier
1972165637
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BELLEVUE MEDICAL CLINIC LLC
Practice address
8725 S Tacoma Way
Lakewood, WA 98499-4544
Phone
(253) 535-5552
NPI assigned
Jul 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Authorized official

Name
Sandy Clemens
Title
Contract Coordinator
Phone
(206) 538-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

8725 S Tacoma Way
Lakewood, WA 98499-4544

Mailing address

8725 S Tacoma Way
Lakewood, WA 98499-4544
Phone (253) 535-5552

National Provider Directory

National Provider Directory

Locations

8725 South Tacoma Way
Tacoma, WA 98499
Phone (253) 535-5552

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1972165637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8725 S TACOMA WAY",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994544",
            "telephone_number": "253-535-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 S TACOMA WAY",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994544",
            "telephone_number": "253-535-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVUE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "CONTRACT COORDINATOR",
        "authorized_official_telephone_number": "206-538-6300"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.