Provider Demographics
NPI:1962496083
Name:SEARCH, BEVERLY M (ARNP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:M
Last Name:SEARCH
Suffix:
Gender:F
Credentials:ARNP
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 160
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:WA
Mailing Address - Zip Code:98611-0160
Mailing Address - Country:US
Mailing Address - Phone:360-274-2353
Mailing Address - Fax:360-274-2353
Practice Address - Street 1:139 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:WA
Practice Address - Zip Code:98611
Practice Address - Country:US
Practice Address - Phone:360-274-2353
Practice Address - Fax:360-274-5354
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00091627163W00000X, 163WX0106X
WAAP30001705363L00000X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9602632Medicaid
WA0233520OtherLABOR & INDUSTRIES
WA8938465OtherCRIME VICTIMS
OR277677Medicaid
P00684089Medicare PIN
R34218Medicare UPIN
WA9602632Medicaid