| Doctor Name: | JADA BEA |
| NPI Number: | 1437402096 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP-A |
| License Number: | SP 60213104 |
| Business Practice Address: | 630 24th St Washougal, WA - 986711652 |
| Business Phone Number: | 3609543800 |
| Business Fax Number: | |
| Mailing Address: | 4855 Evergreen Way, WASHOUGAL |
| State: | WA |
| Postal Code: | 986719176 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/19/2012 |
| NPI Last Update Date: | 10/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | SP 60213104 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |