Provider Demographics
NPI:1770968638
Name:BECK, CHRISTINE (PHD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:REECE
Other - Middle Name:
Other - Last Name:HENRICHS-BECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:917 SW OAK ST STE 407
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2838
Mailing Address - Country:US
Mailing Address - Phone:262-716-9243
Mailing Address - Fax:
Practice Address - Street 1:917 SW OAK ST STE 407
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2838
Practice Address - Country:US
Practice Address - Phone:541-357-7814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3001103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling