Healthcare Provider Details

I. General information

NPI: 1497456750
Provider Name (Legal Business Name): EMILY BECK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date: 12/12/2025
Reactivation Date: 12/17/2025

III. Provider practice location address

8770 SW SCOFFINS ST
PORTLAND OR
97223-6226
US

IV. Provider business mailing address

5415 SW WESTGATE DR
PORTLAND OR
97221-2409
US

V. Phone/Fax

Practice location:
  • Phone: 503-684-1424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: