Provider Demographics
NPI:1205143112
Name:BEEBE, MYCHAL ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:MYCHAL
Middle Name:ELIZABETH
Last Name:BEEBE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 MURDOCK ST
Mailing Address - Street 2:STE B
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-1426
Mailing Address - Country:US
Mailing Address - Phone:360-855-1021
Mailing Address - Fax:360-855-0356
Practice Address - Street 1:700 MURDOCK ST
Practice Address - Street 2:STE B
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-1426
Practice Address - Country:US
Practice Address - Phone:360-855-1021
Practice Address - Fax:360-855-0356
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60164151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor