Provider Demographics
NPI:1629312434
Name:BEH, DEEANNA MARIE (LMP)
Entity Type:Individual
Prefix:
First Name:DEEANNA
Middle Name:MARIE
Last Name:BEH
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E GEORGE HOPPER RD
Mailing Address - Street 2:SUITE #106
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3154
Mailing Address - Country:US
Mailing Address - Phone:360-707-2300
Mailing Address - Fax:360-707-2026
Practice Address - Street 1:325 E GEORGE HOPPER RD
Practice Address - Street 2:SUITE #106
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3154
Practice Address - Country:US
Practice Address - Phone:360-707-2300
Practice Address - Fax:360-707-2026
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00008701174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist