Provider Demographics
NPI:1073124491
Name:BECK, ALANA BRIANNE
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:BRIANNE
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-357-3310
Mailing Address - Fax:425-357-3317
Practice Address - Street 1:1818 121ST ST SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-5985
Practice Address - Country:US
Practice Address - Phone:425-357-3310
Practice Address - Fax:425-357-3317
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61012005363L00000X
WAAP61012005363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner