Provider Demographics
NPI:1477967016
Name:BEECROFT, ALICIA J (ARNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:J
Last Name:BEECROFT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:J
Other - Last Name:GAMRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:1600 E JEFFERSON ST STE 510
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5648
Practice Address - Country:US
Practice Address - Phone:206-320-4888
Practice Address - Fax:206-320-4203
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60366191163W00000X
WAAP60486240363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1477967016Medicaid