Healthcare Provider Details

I. General information

NPI: 1477712206
Provider Name (Legal Business Name): NOEL BECKFORD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 12/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 COOKS HILL RD
CENTRALIA WA
98531-9073
US

IV. Provider business mailing address

1825 FOREST HILL DR SE
OLYMPIA WA
98501-3736
US

V. Phone/Fax

Practice location:
  • Phone: 800-370-4916
  • Fax:
Mailing address:
  • Phone: 360-943-8470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD00027037
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: