Basic Information
Provider Information
NPI: 1154665842
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BELL
FirstName: LOWELL
MiddleName: TERRY
NamePrefix: MR.
NameSuffix:  
Credential: M.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8501 NE 59TH CIRCLE
Address2:  
City: VANCOUVER
State: WA
PostalCode: 98662
CountryCode: US
TelephoneNumber: 3608824704
FaxNumber:  
Practice Location
Address1: 7507 NE 51ST ST
Address2:  
City: VANCOUVER
State: WA
PostalCode: 986626007
CountryCode: US
TelephoneNumber: 3609061190
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/19/2012
LastUpdateDate: 11/19/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
170300000XLH00006920WAY Other Service ProvidersGenetic Counselor, MS 

ID Information
IDTypeStateIssuerDescription
101YA00000X01WACOUNSELOROTHER


Home