# BELLEVUE MEDICAL CENTER

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

## Provider details

- **NPI number:** 1750754883
- **Authorized official:** RAYMON KOONER (PRESIDENT)
- **Authorized official phone:** (425) 577-1517

## Contact information

- **Practice address:** 10655 NE 4TH ST, STE 101, BELLEVUE, WA 98004-5035
- **Practice address phone:** (425) 577-1517
- **Practice address fax:** (425) 454-7767
- **Mailing address:** 10655 NE 4TH ST, STE 101, BELLEVUE, WA 98004-5035
- **Mailing address phone:** (425) 577-1517
- **Mailing address fax:** (425) 454-7767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10004437 | WA | Yes |

## Other

- **Enumeration date:** 11/11/2015
- **Last updated:** 11/11/2015