Provider Demographics
NPI:1841366168
Name:BAILEY, BEVERLY CHRISTINE (LMP)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:CHRISTINE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1312 W DAWN AVE
Mailing Address - Street 2:UPPER LEVEL
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-9619
Mailing Address - Country:US
Mailing Address - Phone:509-701-1578
Mailing Address - Fax:509-489-2485
Practice Address - Street 1:2010 N MADISON ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-4411
Practice Address - Country:US
Practice Address - Phone:509-701-1578
Practice Address - Fax:509-489-2485
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011289225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist