Healthcare Provider Details

I. General information

NPI: 1013421809
Provider Name (Legal Business Name): DIANDREA JOAN BECKMAN MSW, LSWAIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2017
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 214TH ST SW
MOUNTLAKE TERRACE WA
98043
US

IV. Provider business mailing address

639 CULLUM AVE STE 854
RICHLAND WA
99352
US

V. Phone/Fax

Practice location:
  • Phone: 425-835-2352
  • Fax:
Mailing address:
  • Phone:
  • Fax: 509-292-4155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSC61312311
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC61312311
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: