MEDICARE: DR. DYLAN JONATHAN BEAMER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH60784950	WA

General Provider Information

NPI Number	:	1164932752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DYLAN JONATHAN BEAMER DC

Provider Business Mailing Address
First Line	:	1210 PUGET ST
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98229-2144
Country	:	US
Telephone Number	:	503-806-7558
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 LAKEWAY DR STE 3
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98229-2034
Country	:	US
Telephone Number	:	503-806-7558
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2017
Last Update Date	:	05/06/2019

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