# PHYSICAL MEDICINE OF BELLEVUE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528316692
- **Authorized official:** DR. MIKHAIL V. MAKOVSKI MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (425) 452-9280

## Contact information

- **Practice address:** 555 108TH AVE NE STE 1, BELLEVUE, WA 98004-5578
- **Practice address phone:** (425) 452-9280
- **Practice address fax:** (425) 452-9306
- **Mailing address:** 555 108TH AVE NE STE 1, BELLEVUE, WA 98004-5578
- **Mailing address phone:** (425) 452-9280
- **Mailing address fax:** (425) 452-9306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CH00003438 | WA | — |
| 111N00000X | Chiropractor | CH60266885 | WA | — |
| 163WG0000X | General Practice Registered Nurse | AP60184962 | WA | — |
| 208D00000X | General Practice Physician | MD00039986 | WA | Yes |
| 225700000X | Massage Therapist | MA60147179 | WA | — |

## Other

- **Enumeration date:** 08/21/2012
- **Last updated:** 02/07/2013