Provider Demographics
NPI:1578612875
Name:BECK OWNES, ANEA (LMP)
Entity Type:Individual
Prefix:
First Name:ANEA
Middle Name:
Last Name:BECK OWNES
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 CALAWAH WAY
Mailing Address - Street 2:
Mailing Address - City:FORKS
Mailing Address - State:WA
Mailing Address - Zip Code:98331-9713
Mailing Address - Country:US
Mailing Address - Phone:360-374-5550
Mailing Address - Fax:360-374-9598
Practice Address - Street 1:230 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:FORKS
Practice Address - State:WA
Practice Address - Zip Code:98331
Practice Address - Country:US
Practice Address - Phone:360-374-5550
Practice Address - Fax:360-374-9598
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015427225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0197663OtherLABOR & INDUSTRIES
WAMA00015427OtherLICENSED MASSAGE PRACTION