Provider Demographics
NPI:1790331346
Name:BECKER, MARIANNE GERALYN (RN)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:GERALYN
Last Name:BECKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 E CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:BELFAIR
Mailing Address - State:WA
Mailing Address - Zip Code:98528-9168
Mailing Address - Country:US
Mailing Address - Phone:425-599-6994
Mailing Address - Fax:
Practice Address - Street 1:4012 WIGGINS RD SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-4372
Practice Address - Country:US
Practice Address - Phone:253-533-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00098940163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse