Active NPI
Stacey Elizabeth Beaudoin, AUD
- Audiologist
- Bellevue, WA
National Provider Identifier
1861546913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- LD00004422
- Practice address
- 1135 116TH Ave NE
Suite 500
Bellevue, WA 98004 - Phone
- (425) 454-3938
- Fax
- (425) 454-2568
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | LD00004422 | WA | Primary |
Addresses
Primary practice location
1135 116TH Ave NE
Suite 500
Bellevue, WA 98004
Mailing address
1135 116TH Ave NE Suite 500
Bellevue, WA 98004
Phone (425) 454-3938
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65043U | Other | WA | REGENCE BLUESHIELD |
| 8476038 | Medicaid | WA | |
| 0218801 | Other | WA | LABOR & INDUSTRY |
Other names 1
- Stacey E Strunks
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD00004422 | WA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean S Ricketts MD Inc PS | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Bellevue, WA
- NPI 1629231410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208390400000",
"number": "1861546913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1135 116TH AVE NE SUITE 500",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "98004",
"telephone_number": "425-454-3938",
"fax_number": "425-454-2568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 116TH AVE NE",
"address_2": "SUITE 500",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "98004",
"telephone_number": "425-454-3938",
"fax_number": "425-454-2568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUDOIN",
"first_name": "STACEY",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2008-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WA",
"license": "LD00004422",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUESHIELD",
"identifier": "65043U",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8476038",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "0218801",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STACEY",
"last_name": "STRUNKS",
"middle_name": "E",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.