Healthcare Provider Details

I. General information

NPI: 1750435210
Provider Name (Legal Business Name): DEBRA S BECK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/18/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 E. 13TH AVENUE
EUGENE OR
97403
US

IV. Provider business mailing address

3261 JAYHAWK CT
EUGENE OR
97405-6266
US

V. Phone/Fax

Practice location:
  • Phone: 541-341-8393
  • Fax:
Mailing address:
  • Phone: 131-432-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number092018
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number201809150RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: