Provider Demographics
NPI:1710345558
Name:BECKER, PAULETTE LYTLE (RN, MSN)
Entity Type:Individual
Prefix:
First Name:PAULETTE
Middle Name:LYTLE
Last Name:BECKER
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 SOUNDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-9582
Mailing Address - Country:US
Mailing Address - Phone:360-321-2250
Mailing Address - Fax:419-831-3514
Practice Address - Street 1:2270 SOUNDVIEW DR
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-9582
Practice Address - Country:US
Practice Address - Phone:360-321-2250
Practice Address - Fax:419-831-3514
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN 00136707163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator