Individual
MADISON BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP, RN
Contact information
Practice address
3050 SE DIVISION ST STE 215, PORTLAND, OR 97202-1997
(503) 622-8964
(503) 715-5469
Mailing address
1121 REMINGTON ST, FORT COLLINS, CO 80524-3735
(970) 237-9378
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
1666456
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10003916
OR
Other
Enumeration date
12/08/2022
Last updated
03/31/2025
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