OrganizationActive
Bellevue Obgyn LLC
NPI 1104124247 · Obstetrics & Gynecology Physician · Bellevue, WA
Provider details
- NPI number
- 1104124247
- Entity type
- Organization
- Primary specialty
- Obstetrics & Gynecology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mark Fan, Member(425) 698-1588
- License
- MD60122545 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1515 116th Ave Ne
205
Bellevue, WA 98004-3811
Phone: (425) 698-1588
Street-level locationGet directions
Mailing address
1515 116th Ave Ne
Bellevue, WA 98004-3811
Registry dates
- Enumerated
- 2011-03-13
- Last updated
- 2012-08-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.