Provider Demographics
NPI:1568898104
Name:BESHORE, JANE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:E
Last Name:BESHORE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 COVE DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8608
Mailing Address - Country:US
Mailing Address - Phone:360-301-3044
Mailing Address - Fax:360-246-1949
Practice Address - Street 1:2255 COVE DR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-8608
Practice Address - Country:US
Practice Address - Phone:360-301-3044
Practice Address - Fax:360-246-1949
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-14
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001415103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist