Provider Demographics
NPI:1205295466
Name:MILLS, BETH ANN (LAC)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:MILLS
Suffix:
Gender:
Credentials:LAC
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 14425
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99214-0425
Mailing Address - Country:US
Mailing Address - Phone:509-240-9339
Mailing Address - Fax:509-282-5663
Practice Address - Street 1:919 N PINES RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4932
Practice Address - Country:US
Practice Address - Phone:509-240-9339
Practice Address - Fax:509-282-5663
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61408819171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1003511064OtherEMPLOYER