Provider Demographics
NPI:1235577222
Name:BARRETT, JOANNE THYME (SLP)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:THYME
Last Name:BARRETT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:JOANNE
Other - Middle Name:BARRETT
Other - Last Name:QUIRK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:21730 HOBSON RD SE
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-8924
Mailing Address - Country:US
Mailing Address - Phone:360-894-0502
Mailing Address - Fax:
Practice Address - Street 1:213 RAINIER AVE
Practice Address - Street 2:
Practice Address - City:EATONVILLE
Practice Address - State:WA
Practice Address - Zip Code:98328
Practice Address - Country:US
Practice Address - Phone:360-879-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00004434235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
12097477OtherASHA
WAQUIRKJB491D3OtherWASHINGTON DRIVER LICENSE
WALL 00004434OtherWASHINGTON STATE DEPARTMENT OF HEALTH