Healthcare Provider Details

I. General information

NPI: 1477967016
Provider Name (Legal Business Name): ALICIA J BEECROFT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA J GAMRATH ARNP

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E JEFFERSON ST STE 510
SEATTLE WA
98122-5648
US

IV. Provider business mailing address

PO BOX 25608
SALT LAKE CITY UT
84125-0608
US

V. Phone/Fax

Practice location:
  • Phone: 206-320-4888
  • Fax: 206-320-4203
Mailing address:
  • Phone: 206-320-4476
  • Fax: 206-568-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60366191
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60486240
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: