Provider Demographics
NPI:1043268147
Name:BEALE, BARBARA ELLEN (LAC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ELLEN
Last Name:BEALE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 NE 54TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-6423
Mailing Address - Country:US
Mailing Address - Phone:360-693-2848
Mailing Address - Fax:360-693-1678
Practice Address - Street 1:3509 NE 54TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-6423
Practice Address - Country:US
Practice Address - Phone:360-693-2848
Practice Address - Fax:360-693-1678
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000371171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist