| Doctor Name: | MICHAEL BEAUCHAINE |
| NPI Number: | 1255672465 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | PA174762 |
| Business Practice Address: | 2020 8th Ave Suite 200 West Linn, OR - 97068 |
| Business Phone Number: | 5035121212 |
| Business Fax Number: | |
| Mailing Address: | 549 Ne10th Ave, CANBY |
| State: | OR |
| Postal Code: | 970132904 |
| Phone Number: | 8433120945 |
| Fax Number: | 5035121213 |
| NPI Enumeration Date: | 03/13/2013 |
| NPI Last Update Date: | 10/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA174762 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |