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NPI Code Detail

MEDICARE: MS. JACQUELINE BECKWITH FNP

MEDICARE: MS. JACQUELINE BECKWITH FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner200650004NPOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366420739
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JACQUELINE BECKWITH FNP
Provider Business Mailing Address
First Line : 2051 KAEN RD
Second Line : STE 367
City : OREGON CITY
State : OR
Zip : 97045-4035
Country : US
Telephone Number : 503-742-5300
Fax Number : 503-742-5979
Provider Business Practice Location Address
First Line : 37400 BELL ST
Second Line :
City : SANDY
State : OR
Zip : 97055-7868
Country : US
Telephone Number : 503-668-3483
Fax Number : 503-668-1892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 10/18/2016

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