1831858216 NPI number — CHYANE LEIANN BEASLEY RACC, CPC

Table of content: CHYANE LEIANN BEASLEY RACC, CPC (NPI 1831858216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831858216 NPI number — CHYANE LEIANN BEASLEY RACC, CPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEASLEY
Provider First Name:
CHYANE
Provider Middle Name:
LEIANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RACC, CPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAILEY
Provider Other First Name:
CHYANE
Provider Other Middle Name:
LEIANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RACC, CPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831858216
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1128 BROADWAY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONGVIEW
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98632-3831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-749-0177
Provider Business Mailing Address Fax Number:
360-423-5128

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1128 BROADWAY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONGVIEW
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98632-3831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-827-5220
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 175T00000X , with the licence number:  1831858216 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com