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Individual

MICHAEL BEAUCHAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2020 8TH AVE, SUITE 200, WEST LINN, OR 97068
(503) 512-1212
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4229-23
WI
363AM0700X
Medical Physician Assistant
PA174762
OR

Other

Enumeration date
03/13/2013
Last updated
11/02/2017
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