Provider Demographics
NPI:1457247363
Name:BECHARD, JONATHAN D (LMT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:D
Last Name:BECHARD
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 N STATELINE RD
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-8265
Mailing Address - Country:US
Mailing Address - Phone:208-818-8565
Mailing Address - Fax:
Practice Address - Street 1:1625 W 4TH AVE LOWR LEVEL200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-5620
Practice Address - Country:US
Practice Address - Phone:509-624-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61628188225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist