MEDICARE: REBEKAH A BEARDSLEY

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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1942714191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH A BEARDSLEY

Provider Business Mailing Address
First Line	:	2105 CONTINENTAL PL STE A
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-4104
Country	:	US
Telephone Number	:	360-399-6900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2105 CONTINENTAL PL STE A
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-4104
Country	:	US
Telephone Number	:	360-399-6900
Fax Number	:

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

Provider Enumeration Date	:	11/27/2017
Last Update Date	:	08/31/2021

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Directions to “ REBEKAH A BEARDSLEY ” Practice Location

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