Provider Demographics
NPI:1275087637
Name:BEYERLIN, DEANA (ELECTROLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:DEANA
Middle Name:
Last Name:BEYERLIN
Suffix:
Gender:F
Credentials:ELECTROLOGIST
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 1137
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-0053
Mailing Address - Country:US
Mailing Address - Phone:541-214-7126
Mailing Address - Fax:
Practice Address - Street 1:2496 ADAMS ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2241
Practice Address - Country:US
Practice Address - Phone:541-214-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10177367225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist