Provider Demographics
NPI:1225121890
Name:CARTER, BECKY SUE (DNP, NNP-BC)
Entity Type:Individual
Prefix:DR
First Name:BECKY
Middle Name:SUE
Last Name:CARTER
Suffix:
Gender:F
Credentials:DNP, NNP-BC
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:SUE
Other - Last Name:REICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, NNP-BC
Mailing Address - Street 1:400 S 43RD ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5714
Mailing Address - Country:US
Mailing Address - Phone:425-656-5525
Mailing Address - Fax:425-656-4228
Practice Address - Street 1:400 S 43RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5714
Practice Address - Country:US
Practice Address - Phone:425-656-5525
Practice Address - Fax:425-656-4228
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005099363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9629957Medicaid
WAAB29336Medicare ID - Type Unspecified
WA9629957Medicaid