Provider Demographics
NPI:1336595644
Name:BEBAWI, JOANNA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:BEBAWI
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 PACIFIC AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4168
Mailing Address - Country:US
Mailing Address - Phone:425-258-7318
Mailing Address - Fax:425-258-7618
Practice Address - Street 1:900 PACIFIC AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4168
Practice Address - Country:US
Practice Address - Phone:425-258-7318
Practice Address - Fax:425-258-7618
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60633204235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist