| NPI | 1720972961 |
|---|---|
| Doing Business As | BELLEVUE PSYCHIATRY |
| Entity Type | Organization |
| Authorized Contact | MIGUEL DE LA MORA Owner 509-910-4559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-11-27 |