Provider Demographics
NPI:1831858216
Name:BEASLEY, CHYANE LEIANN (RACC, CPC)
Entity type:Individual
Prefix:
First Name:CHYANE
Middle Name:LEIANN
Last Name:BEASLEY
Suffix:
Gender:
Credentials:RACC, CPC
Other - Prefix:
Other - First Name:CHYANE
Other - Middle Name:LEIANN
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RACC, CPC
Mailing Address - Street 1:1128 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3831
Mailing Address - Country:US
Mailing Address - Phone:360-749-0177
Mailing Address - Fax:360-423-5128
Practice Address - Street 1:1128 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3831
Practice Address - Country:US
Practice Address - Phone:360-827-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1831858216175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist