Provider Demographics
NPI:1790570190
Name:BEAL, JEANETTE MICHELLE (CPC)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:MICHELLE
Last Name:BEAL
Suffix:
Gender:
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4714 NE 72ND AVE APT 118
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-8119
Mailing Address - Country:US
Mailing Address - Phone:360-831-7553
Mailing Address - Fax:
Practice Address - Street 1:4714 NE 72ND AVE APT 118
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-8119
Practice Address - Country:US
Practice Address - Phone:360-831-7553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist