MEDICARE: KRISTINE BECK PA-C

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	363A00000X	Physician Assistant	3235	CO
2	363A00000X	Physician Assistant	135878	AK
3	363A00000X	Physician Assistant	PA60986007	WA

General Provider Information

NPI Number	:	1346538964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE BECK PA-C

Provider Business Mailing Address
First Line	:	709 W ORCHARD DR STE 4
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-1766
Country	:	US
Telephone Number	:	307-631-4211
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 W STEWART RD STE 104
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-9607
Country	:	US
Telephone Number	:	360-395-2938
Fax Number	:

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

Provider Enumeration Date	:	07/17/2011
Last Update Date	:	06/20/2024

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Directions to “ KRISTINE BECK PA-C” Practice Location

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