Individual
MRS. SOMPHONE S. BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP
Contact information
Practice address
2555 NE BELVUE ST, CORVALLIS, OR 97330-4202
(541) 768-2220
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200850063NP FNP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500601707
—
OR
Enumeration date
07/14/2008
Last updated
11/05/2020
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