Provider Demographics
NPI:1871065367
Name:BELL-KILWEIN, JANINE MARCELLA
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:MARCELLA
Last Name:BELL-KILWEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17600 TALBOT RD S STE 3
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5771
Mailing Address - Country:US
Mailing Address - Phone:425-254-2899
Mailing Address - Fax:
Practice Address - Street 1:17600 TALBOT RD S STE 3
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5771
Practice Address - Country:US
Practice Address - Phone:425-254-2899
Practice Address - Fax:425-254-2522
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60760565101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)