Provider Demographics
NPI:1518291491
Name:BEECHINOR, SHAWNA MARIE (PA)
Entity Type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:MARIE
Last Name:BEECHINOR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:7733 W EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-9020
Mailing Address - Country:US
Mailing Address - Phone:208-376-4265
Mailing Address - Fax:208-939-5010
Practice Address - Street 1:161 E MALLARD DR
Practice Address - Street 2:SUITE 130
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-5015
Practice Address - Country:US
Practice Address - Phone:208-991-5207
Practice Address - Fax:208-639-6622
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2021-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDPA-817363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical