Tracey Anne Beagle

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

12220 SW 2ND St
Beaverton, OR 97005-2828

Phone

(503) 644-7242

NPI assigned

Oct 23, 2006

Last updated

Oct 27, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1265515027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12220 SW 2ND ST",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052828",
            "telephone_number": "503-644-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12220 SW 2ND ST",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052828",
            "telephone_number": "503-644-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAGLE",
        "first_name": "TRACEY",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Elaine Desmarais Bawcom
• Julie Baxter
• Samuel West Baynes III, RPH
• Emilia Christina Bazan-Grow, DNP,FNP
• Kristin A Bazor, RDH
• Heidi Beale
• Jeffery Beale, LMT
• Naomi J Beale, MS SLP
• Megan Elizabeth Beam
• Lori Bearden, OT

• Professional Counselor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.