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David John Beauchene Jr., ATC, AT/L

Community Health Worker in Ellensburg, WA. Individual provider (NPI-1).

NPI number1457787293
StatusActive
Last updated in NPPESSep 25, 2013

Details

NPI
1457787293
Entity type
Individual (NPI-1)
Name
Mr. David John Beauchene Jr.
Credential
ATC, AT/L
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 25, 2013
Last updated
Sep 25, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health WorkerA1 60298159WAYes

Practice location

400 E University Way
Ellensburg, WA 98926-7502

Phone 509-963-3238

Mailing address

6224 48th St E
Puyallup, WA 98371-3619

Phone 253-820-7205

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