Provider Demographics
NPI:1164793337
Name:BEACH, ANNE (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:BEACH
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 152ND AVE NE BLDG 6
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5552
Mailing Address - Country:US
Mailing Address - Phone:425-867-0475
Mailing Address - Fax:
Practice Address - Street 1:2721 152ND AVE NE BLDG 6
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5552
Practice Address - Country:US
Practice Address - Phone:425-867-0475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist