Organization
DR. CHARLES G. BELLVILLE, MD, LLC
Active
Other names
charles g bellville sole mbr
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES GEORGE BELLVILLE MD (0WNER)
(503) 274-2661
Entity
Organization
Contact information
Practice address
909 SW SAINT CLAIR AVE, PORTLAND, OR 97205-1300
(503) 274-2661
(503) 692-0688
Mailing address
909 SW SAINT CLAIR AVE, PORTLAND, OR 97205-1300
(503) 274-2661
(503) 692-0688
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
11983
OR
Other
Enumeration date
11/08/2011
Last updated
08/16/2013
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