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Individual

JOHNNY STEPHEN BELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
117 SPRUCE ST., ILWACO, WA 98624-0000
(360) 642-2662
(360) 642-2663
Mailing address
PO BOX 500, TOKELAND, WA 98590-0500
(360) 267-8138
(360) 267-6217

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OP00001380
WA
207Q00000X
Family Medicine Physician
Primary
OP00001380
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1077452
WA
01
25713
L & I
WA
Enumeration date
07/21/2006
Last updated
11/03/2015
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