Healthcare Provider Details

I. General information

NPI: 1235552159
Provider Name (Legal Business Name): KRISTI MARIE BEERS LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2014
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 W TAPPS DR E
LAKE TAPPS WA
98391-9176
US

IV. Provider business mailing address

3920 WEST TAPPS DR E
LAKE TAPPS WA
98391
US

V. Phone/Fax

Practice location:
  • Phone: 253-862-8001
  • Fax: 253-826-4792
Mailing address:
  • Phone: 253-862-8001
  • Fax: 253-826-4792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60444973
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: