Provider Demographics
NPI:1386605129
Name:BEECHLY, RICHARD E (CRNA)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:E
Last Name:BEECHLY
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:5319 SW WESTGATE DR
Mailing Address - Street 2:241
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-2432
Mailing Address - Country:US
Mailing Address - Phone:503-297-7223
Mailing Address - Fax:503-297-7603
Practice Address - Street 1:2699 N 17TH ST
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420
Practice Address - Country:US
Practice Address - Phone:541-269-7358
Practice Address - Fax:541-269-0677
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR089006350367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR297669Medicaid
OR840206000OtherREGENCE BCBSO
ORR117700Medicare PIN
S04673Medicare UPIN