Provider Demographics
NPI:1184004731
Name:BECK, PAMELA JANE
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JANE
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:JANE
Other - Last Name:SCHOONOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42865 SW KLICKITAT AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-8536
Mailing Address - Country:US
Mailing Address - Phone:503-201-4759
Mailing Address - Fax:
Practice Address - Street 1:4110 PACIFIC AVE STE 102-B
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-2383
Practice Address - Country:US
Practice Address - Phone:503-604-5400
Practice Address - Fax:503-601-5410
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional