Provider Demographics
NPI:1376555664
Name:BEACHY, RYAN JOSEPH (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:JOSEPH
Last Name:BEACHY
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:107 E MOUNTAIN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-5312
Mailing Address - Country:US
Mailing Address - Phone:509-962-6348
Mailing Address - Fax:509-962-2003
Practice Address - Street 1:3909 CREEKSIDE LOOP STE 115
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4880
Practice Address - Country:US
Practice Address - Phone:509-574-6095
Practice Address - Fax:509-574-6098
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10005054363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant