Provider Demographics
NPI:1205453453
Name:BECKMANN, SCOTT RYAN (CCP)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:RYAN
Last Name:BECKMANN
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 DAVIS RD S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-9836
Mailing Address - Country:US
Mailing Address - Phone:503-871-7803
Mailing Address - Fax:
Practice Address - Street 1:2117 DAVIS RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-9836
Practice Address - Country:US
Practice Address - Phone:503-871-7803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionistGroup - Single Specialty