DR. CHARLES G. BELLVILLE, MD, LLC
Ambulatory Health at Saint Clair Ave, Portland, OR

License number
Oregon 11983
Category
Ambulatory Health
Type
Adult Mental Health
Owner
Name: DR. CHARLES GEORGE BELLVILLE MD
Title: 0WNER
Phone: (503) 274-2661
Address
Address
909 SW Saint Clair Ave, Portland, OR 97205
National Provider ID: 1487931382
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DR. CHARLES G. BELLVILLE, MD, LLC

909 SW St Clair Ave, Portland, OR 97205

Registration:
Jan 28, 2011
State ID:
74491391
Business type:
DOMESTIC LIMITED LIABILITY COMPANY
Agent:
Charles Gbellville,909 SW St Clair Ave, Portland, OR 97205 (Physical)

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