MEDICARE: JOALYCE HARRIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1740139922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOALYCE HARRIS

Provider Business Mailing Address
First Line	:	16215 11TH AVE E
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98445-2380
Country	:	US
Telephone Number	:	206-330-3317
Fax Number	:

Provider Business Practice Location Address
First Line	:	CBPI, LLC 1003 7TH AVE STE A
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98033
Country	:	US
Telephone Number	:	425-658-3016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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