Healthcare Provider Details

I. General information

NPI: 1346159977
Provider Name (Legal Business Name): CARRIE BECK MPH, RDN, CD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13818 SE 36TH ST
VANCOUVER WA
98683-7700
US

IV. Provider business mailing address

13818 SE 36TH ST
VANCOUVER WA
98683-7700
US

V. Phone/Fax

Practice location:
  • Phone: 360-314-5511
  • Fax:
Mailing address:
  • Phone: 360-314-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDIET.DI.60200444
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: