Provider Demographics
NPI:1912437393
Name:BEAR, JOY JAYNE
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:JAYNE
Last Name:BEAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3656B BECK RD
Mailing Address - Street 2:
Mailing Address - City:RICE
Mailing Address - State:WA
Mailing Address - Zip Code:99167-9728
Mailing Address - Country:US
Mailing Address - Phone:509-680-5765
Mailing Address - Fax:
Practice Address - Street 1:151 BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-8676
Practice Address - Country:US
Practice Address - Phone:509-684-4539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60499185224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant