Individual
MRS. ANGELA FAYE BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2400 NW KINGS BLVD, CORVALLIS, OR 97330
(541) 757-2400
(541) 752-0931
Mailing address
2400 NW KINGS BLVD, CORVALLIS, OR 97330
(541) 757-2400
(541) 752-0931
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10004906
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8475667
—
WA
Enumeration date
06/16/2006
Last updated
12/15/2016
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