Provider Demographics
NPI:1639423775
Name:BEAUCHAMP, GEETHA RACHEL (OTR/L, CLC)
Entity Type:Individual
Prefix:MRS
First Name:GEETHA
Middle Name:RACHEL
Last Name:BEAUCHAMP
Suffix:
Gender:F
Credentials:OTR/L, CLC
Other - Prefix:
Other - First Name:GEETHA
Other - Middle Name:RACHEL
Other - Last Name:MATHEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1610 C ST STE 102
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3400
Mailing Address - Country:US
Mailing Address - Phone:360-836-4265
Mailing Address - Fax:
Practice Address - Street 1:1610 C ST STE 102
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3400
Practice Address - Country:US
Practice Address - Phone:360-836-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR281426225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist