Provider Demographics
NPI:1801048236
Name:BEESON, BARBARA (PA)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:BEESON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14731 AURORA AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-6547
Mailing Address - Country:US
Mailing Address - Phone:206-365-0220
Mailing Address - Fax:206-365-6436
Practice Address - Street 1:14731 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-6547
Practice Address - Country:US
Practice Address - Phone:206-365-0220
Practice Address - Fax:206-365-6436
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA 10002788363A00000X
WARN 00052309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAS92759Medicare UPIN