Provider Demographics
NPI:1558308320
Name:BECK, JAMES WALTER (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WALTER
Last Name:BECK
Suffix:
Gender:M
Credentials:MD
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 2605
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98907-2605
Mailing Address - Country:US
Mailing Address - Phone:509-454-4143
Mailing Address - Fax:509-454-4115
Practice Address - Street 1:310 TORBETT ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2604
Practice Address - Country:US
Practice Address - Phone:509-946-1695
Practice Address - Fax:509-946-7666
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020481207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0181367OtherLABOR & INDUSTRIES
WA1027085Medicaid
WAA07495Medicare UPIN
WA1027085Medicaid