Healthcare Provider Details

I. General information

NPI: 1245356815
Provider Name (Legal Business Name): JOYCE A BECK ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 NW KINGWOOD AVE SUITE B
REDMOND OR
97756-1324
US

IV. Provider business mailing address

236 NW KINGWOOD AVE SUITE B
REDMOND OR
97756-1324
US

V. Phone/Fax

Practice location:
  • Phone: 541-548-7134
  • Fax: 541-322-1741
Mailing address:
  • Phone: 541-548-7134
  • Fax: 541-322-1741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: