Healthcare Provider Details

I. General information

NPI: 1730798901
Provider Name (Legal Business Name): ANTHONY H. J BECHER IV
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2020
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 GEORGIANA ST
PORT ANGELES WA
98362-3911
US

IV. Provider business mailing address

907 GEORGIANA ST
PORT ANGELES WA
98362-3911
US

V. Phone/Fax

Practice location:
  • Phone: 360-565-0999
  • Fax: 360-565-0901
Mailing address:
  • Phone: 360-565-0999
  • Fax: 360-565-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA61139322
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA61139322
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: