Individual
JOHN THOMAS BEARUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
908 TENTH AVE SW, QUINCY, WA 98848
(509) 787-3503
(509) 787-1361
Mailing address
908 TENTH AVE SW, QUINCY, WA 98848
(509) 787-3503
(509) 787-1361
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10001768
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8348575
—
WA
Enumeration date
08/24/2006
Last updated
07/08/2007
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