Provider Demographics
NPI:1699355644
Name:MCCAULEY, BETHANY J (RN)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:J
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 E SPRAGUE AVE # 756
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4397
Mailing Address - Country:US
Mailing Address - Phone:833-977-6777
Mailing Address - Fax:509-293-7234
Practice Address - Street 1:3826 S MERCY LN
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-7069
Practice Address - Country:US
Practice Address - Phone:509-990-8031
Practice Address - Fax:509-293-7234
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00163579163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse