Provider Demographics
NPI:1487166872
Name:BEACHLER, ERIKA JEAN (MT)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:JEAN
Last Name:BEACHLER
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 E BEST AVE STE D
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4878
Mailing Address - Country:US
Mailing Address - Phone:208-771-5735
Mailing Address - Fax:
Practice Address - Street 1:1103 E BEST AVE STE D
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4878
Practice Address - Country:US
Practice Address - Phone:208-771-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMAS-2577225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist