Provider Demographics
NPI:1245356815
Name:BECK, JOYCE A (ANP)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:BECK
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 NW KINGWOOD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1324
Mailing Address - Country:US
Mailing Address - Phone:541-548-7134
Mailing Address - Fax:541-322-1741
Practice Address - Street 1:236 NW KINGWOOD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1324
Practice Address - Country:US
Practice Address - Phone:541-548-7134
Practice Address - Fax:541-322-1741
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP30769Medicare UPIN