Provider Demographics
NPI:1447445408
Name:BEACHY, EUNICE JANE (ARNP)
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:JANE
Last Name:BEACHY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19500 10TH AVE NE
Mailing Address - Street 2:STE 100
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-6331
Mailing Address - Country:US
Mailing Address - Phone:360-598-7500
Mailing Address - Fax:360-598-7505
Practice Address - Street 1:19500 10TH AVE NE
Practice Address - Street 2:STE 100
Practice Address - City:POULSBOE
Practice Address - State:WA
Practice Address - Zip Code:98370-6331
Practice Address - Country:US
Practice Address - Phone:253-598-7500
Practice Address - Fax:253-598-7505
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007843363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2005138Medicaid