Individual
MR. CHARLES GEORGE BELLVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
909 SW SAINT CLAIR AVE, PORTLAND, OR 97205-1300
(503) 274-2661
(503) 692-4774
Mailing address
909 SW SAINT CLAIR AVE, PORTLAND, OR 97205-1300
(503) 274-2661
(503) 692-4774
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD11983
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OOOOBHQXH
MEDICARE ID
OR
Enumeration date
03/14/2006
Last updated
09/04/2024
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