Provider Demographics
NPI:1730458084
Name:BEECH, MARILYN F (LMT, BCSI)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:F
Last Name:BEECH
Suffix:
Gender:F
Credentials:LMT, BCSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1091
Mailing Address - Street 2:
Mailing Address - City:CARLSBORG
Mailing Address - State:WA
Mailing Address - Zip Code:98324-1091
Mailing Address - Country:US
Mailing Address - Phone:360-477-6855
Mailing Address - Fax:
Practice Address - Street 1:22 MILL RD
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-9408
Practice Address - Country:US
Practice Address - Phone:360-477-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60111878172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0255551OtherLABOR AND INDUSTRIES