Individual
TRACEY ANNE BEAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12220 SW 2ND ST, BEAVERTON, OR 97005-2828
(503) 644-7242
Mailing address
12220 SW 2ND ST, BEAVERTON, OR 97005-2828
(503) 644-7242
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
10/23/2006
Last updated
10/27/2009
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