Provider Demographics
NPI:1679030969
Name:BECKER, NATHAN (MASTER'S IN PMHC)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:BECKER
Suffix:
Gender:M
Credentials:MASTER'S IN PMHC
Other - Prefix:
Other - First Name:NATHAN
Other - Middle Name:
Other - Last Name:SAMARIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1210 SE OAK ST STE 6
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1427
Mailing Address - Country:US
Mailing Address - Phone:503-454-6481
Mailing Address - Fax:
Practice Address - Street 1:1210 SE OAK ST STE 6
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1427
Practice Address - Country:US
Practice Address - Phone:503-454-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health