Provider Demographics
NPI:1578723672
Name:BEEBE, RENEE (IBCLC ,RLC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:BEEBE
Suffix:
Gender:F
Credentials:IBCLC ,RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7325 12TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5619
Mailing Address - Country:US
Mailing Address - Phone:206-356-7252
Mailing Address - Fax:
Practice Address - Street 1:7325 12TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5619
Practice Address - Country:US
Practice Address - Phone:206-356-7252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA19713776174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
19713776OtherINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS