Provider Demographics
NPI:1710976014
Name:BESKE, CINDY L (CNM)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:L
Last Name:BESKE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E. KINCAID STREET
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-814-6724
Mailing Address - Fax:
Practice Address - Street 1:903 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1697
Practice Address - Country:US
Practice Address - Phone:360-435-0242
Practice Address - Fax:360-435-9135
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNP1307367A00000X
WAAP60773706367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2089806Medicaid
ME203981OtherMEDICARE A - BFM
ME102380200Medicaid
P83052Medicare UPIN
ME20Z300OtherMEDICARE A - SWING BED
CO54025079OtherMEDICAID GROUP NUMBER
ME102380301Medicaid
COCO300746Medicare PIN
ME414960099Medicaid
ME201300OtherMEDICARE A
BEME0845Medicare ID - Type Unspecified
ME102380100Medicaid
ME200051OtherMEDICARE B - GROUP
MB0195392OtherDEA
ME102380306Medicaid
COC810212OtherMEDICARE GROUP NUMBER
CO37755021Medicaid