Basic Information
| Provider Information | |||||||||
| NPI: | 1841489242 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAYNTER | ||||||||
| FirstName: | BEATRICE | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1445 | ||||||||
| Address2: | |||||||||
| City: | CHEHALIS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985320378 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607486696 | ||||||||
| FaxNumber: | 3607480627 | ||||||||
| Practice Location | |||||||||
| Address1: | 135 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CHEHALIS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985324817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607486696 | ||||||||
| FaxNumber: | 3607480627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2007 | ||||||||
| LastUpdateDate: | 01/18/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | RC00043967 | WA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.