Provider Demographics
NPI:1578703807
Name:BECK, HARRY JACOB (MT-BC)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:JACOB
Last Name:BECK
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2948 SE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-2321
Mailing Address - Country:US
Mailing Address - Phone:715-294-3828
Mailing Address - Fax:
Practice Address - Street 1:2948 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2321
Practice Address - Country:US
Practice Address - Phone:360-525-3360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA89061225A00000X
225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist