Individual
HEATHER BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3046
(208) 882-4511
(208) 883-6580
Mailing address
PO BOX 28510, SPOKANE, WA 99228-8510
(253) 263-7114
(253) 263-7115
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M-14905
ID
207P00000X
Emergency Medicine Physician
Primary
MD.61076165
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
04/04/2016
Last updated
03/30/2026
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