Provider Demographics
NPI:1942374061
Name:BECKMAN, DEBRA JEAN (BSN, ARNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:JEAN
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:BSN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17303 MILITARY RD S
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3651
Mailing Address - Country:US
Mailing Address - Phone:206-431-9766
Mailing Address - Fax:
Practice Address - Street 1:17303 MILITARY RD S
Practice Address - Street 2:
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-3651
Practice Address - Country:US
Practice Address - Phone:206-431-9766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP0000752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9602327Medicaid