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General NPI Number Information
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NPI Number | 1679582654
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Entity Type | Individual
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Provider Name | NANCY ANN BECKER DO
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 1427 JEFFERSON AVE SUITE 101
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City | ENUMCLAW
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State | WA
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Zip | 98022-3649
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Country | US
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Telephone | 360-825-4466
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Fax | 360-825-2064
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Provider Business Mailing Address
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Address Line | 1427 JEFFERSON AVE SUITE 101
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City | ENUMCLAW
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State | WA
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Zip | 98022-3649
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Country | US
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Telephone | 360-825-4466
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Fax | 360-825-2064
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | OP00001317
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License Number State | WA
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