Healthcare Provider Details

I. General information

NPI: 1538064589
Provider Name (Legal Business Name): TAMMY R. JOHNSON BEARD DACHM, L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10431 PATTERSON AVE RM C25
HENRICO VA
23238
US

IV. Provider business mailing address

10431 PATTERSON AVE RM C25
HENRICO VA
23238
US

V. Phone/Fax

Practice location:
  • Phone: 804-601-6457
  • Fax:
Mailing address:
  • Phone: 804-601-6457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121001250
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: