Individual provider Active NPI

Tracie Bearden, MS, CCC-SLP, CBIST

  • Speech-Language Pathologist
  • Tacoma, WA
National Provider Identifier
1417244294
Registry record updated Mar 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP.LL.60891013 Issued in WA
Practice address
1604 S G St
Tacoma, WA 98405-4440
Phone
(360) 328-1388
NPI assigned
Jun 30, 2011
Last updated
Mar 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP.LL.60891013 WA Primary
Speech-Language Pathologist 235Z00000X SLP.0003775 CO

Addresses

Primary practice location

1604 S G St
Tacoma, WA 98405-4440

Mailing address

1604 S G St
Tacoma, WA 98405-4440
Phone (314) 797-3148

Other practice location 1

121 N Park Ave
Montrose, CO 81401-3768
Phone (970) 615-7065

Other identifiers 1

IdentifierTypeStateIssuer
9000180398MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP.LL.60891013WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Select Rehab St Louis LLC Single Specialty Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772841600000",
    "number": "1417244294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 S G ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054440",
            "telephone_number": "314-797-3148",
            "fax_number": "970-514-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 S G ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054440",
            "telephone_number": "360-328-1388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 N Park Ave",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "CO",
            "postal_code": "814013768",
            "country_code": "US",
            "telephone_number": "970-615-7065",
            "fax_number": "970-514-7457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEARDEN",
        "first_name": "TRACIE",
        "credential": "MS, CCC-SLP, CBIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2026-03-07",
        "certification_date": "2026-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "SLP.LL.60891013",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0003775",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000180398",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.