Provider Demographics
NPI:1538706890
Name:B.E.A. SERVICES LLC
Entity Type:Organization
Organization Name:B.E.A. SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TELLEY
Authorized Official - Middle Name:P
Authorized Official - Last Name:WORMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:HCA
Authorized Official - Phone:206-300-5086
Mailing Address - Street 1:PMB 5054 P.O. BOX 257
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98507
Mailing Address - Country:US
Mailing Address - Phone:206-300-5086
Mailing Address - Fax:
Practice Address - Street 1:3625 SE 5TH PL
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-2836
Practice Address - Country:US
Practice Address - Phone:206-300-5086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty