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Individual

JEREMIAH THOMAS BEALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
9040 JACKSON AVE ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-0001
(253) 968-1000
Mailing address
9040 JACKSON AVE ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-0001
(253) 968-1000

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
325857
TX
164W00000X
Licensed Practical Nurse
LP60845138
WA

Other

Enumeration date
04/17/2018
Last updated
04/17/2018
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